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高频10千赫脊髓刺激为疼痛性糖尿病神经病变患者的糖尿病相关疼痛和生活质量带来长期(24个月)改善。

High-Frequency 10-kHz Spinal Cord Stimulation Provides Long-term (24-Month) Improvements in Diabetes-Related Pain and Quality of Life for Patients with Painful Diabetic Neuropathy.

作者信息

Petersen Erika A, Stauss Thomas G, Scowcroft James A, Jaasma Michael J, Edgar Deborah R, White Judith L, Sills Shawn M, Amirdelfan Kasra, Guirguis Maged N, Xu Jijun, Yu Cong, Nairizi Ali, Patterson Denis G, Creamer Michael J, Galan Vincent, Bundschu Richard H, Mehta Neel D, Sayed Dawood, Lad Shivanand P, DiBenedetto David J, Sethi Khalid A, Goree Johnathan H, Bennett Matthew T, Harrison Nathan J, Israel Atef F, Chang Paul, Wu Paul W, Argoff Charles E, Nasr Christian E, Taylor Rod S, Caraway David L, Mekhail Nagy A

机构信息

Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Advanced Pain Management, Greenfield, WI, USA.

出版信息

J Diabetes Sci Technol. 2024 Oct 6:19322968241268547. doi: 10.1177/19322968241268547.

Abstract

BACKGROUND

The SENZA-PDN study evaluated high-frequency 10-kHz spinal cord stimulation (SCS) for the treatment of painful diabetic neuropathy (PDN). Over 24 months, 10-kHz SCS provided sustained pain relief and improved health-related quality of life. This report presents additional outcomes from the SENZA-PDN study, focusing on diabetes-related pain and quality of life outcomes.

METHODS

The SENZA-PDN study randomized 216 participants with refractory PDN to receive either conventional medical management (CMM) or 10-kHz SCS plus CMM (10-kHz SCS + CMM), allowing crossover after six months if pain relief was insufficient. Postimplantation assessments at 24 months were completed by 142 participants with a permanent 10-kHz SCS implant, comprising 84 initial and 58 crossover recipients. Measures included the Brief Pain Inventory for Diabetic Peripheral Neuropathy (BPI-DPN), Diabetes-Related Quality of Life (DQOL), Global Assessment of Functioning (GAF), and treatment satisfaction.

RESULTS

Over 24 months, 10-kHz SCS treatment significantly reduced pain severity by 66.9% ( < .001; BPI-DPN) and pain interference with mood and daily activities by 65.8% ( < .001; BPI-DPN). Significant improvements were also observed in overall DQOL score ( < .001) and GAF score ( < .001), and 91.5% of participants reported satisfaction with treatment.

CONCLUSIONS

High-frequency 10-kHz SCS significantly decreased pain severity and provided additional clinically meaningful improvements in DQOL and overall functioning for patients with PDN. The robust and sustained benefits over 24 months, coupled with high participant satisfaction, highlight that 10-kHz SCS is an efficacious and comprehensive therapy for patients with PDN.

摘要

背景

SENZA-PDN研究评估了高频10千赫脊髓刺激(SCS)治疗疼痛性糖尿病神经病变(PDN)的效果。在24个月的时间里,10千赫的SCS持续缓解了疼痛,并改善了与健康相关的生活质量。本报告展示了SENZA-PDN研究的其他结果,重点关注与糖尿病相关的疼痛和生活质量结果。

方法

SENZA-PDN研究将216名难治性PDN患者随机分为两组,分别接受传统药物治疗(CMM)或10千赫SCS联合CMM(10千赫SCS + CMM),如果疼痛缓解不充分,6个月后允许交叉治疗。24个月时的植入后评估由142名永久性植入10千赫SCS的参与者完成,其中包括84名初始接受者和58名交叉接受者。测量指标包括糖尿病周围神经病变简明疼痛量表(BPI-DPN)、糖尿病相关生活质量(DQOL)、功能总体评估(GAF)和治疗满意度。

结果

在24个月的时间里,10千赫SCS治疗使疼痛严重程度显著降低了66.9%(P <.001;BPI-DPN),疼痛对情绪和日常活动的干扰降低了65.8%(P <.001;BPI-DPN)。总体DQOL评分(P <.001)和GAF评分(P <.001)也有显著改善,91.5%的参与者表示对治疗满意。

结论

高频10千赫SCS显著降低了疼痛严重程度,并在PDN患者的DQOL和整体功能方面带来了其他具有临床意义的改善。24个月期间强大且持续的益处,加上参与者的高满意度,突出表明10千赫SCS是一种对PDN患者有效的综合治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c87/12701254/e9eca111e4b7/10.1177_19322968241268547-fig1.jpg

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