Selective L4 Dorsal Root Ganglion Stimulation Evokes Pain Relief and Changes of Inflammatory Markers: Part I Profiling of Saliva and Serum Molecular Patterns

2018 ◽  
Vol 22 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Nadine Gravius ◽  
Shafqat R. Chaudhry ◽  
Sajjad Muhammad ◽  
Azize Boström ◽  
Sascha Gravius ◽  
...  
Keyword(s):  
Pain Relief ◽  
Dorsal Root Ganglion ◽  
Inflammatory Markers ◽  
Dorsal Root ◽  
Molecular Patterns

scholarly journals The Effect of Bipolar Pulsed Radiofrequency Treatment on Chronic Lumbosacral Radicular Pain Refractory to Monopolar Pulsed Radiofrequency Treatment

2018 ◽  
Vol 1 (21;1) ◽  
pp. E97-E103 ◽  
Author(s):  
Min Cheol Chang
Keyword(s):  
Pain Relief ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Radicular Pain ◽  
Pulsed Radiofrequency ◽  
Lumbosacral Radiculopathy ◽  
Radiofrequency Treatment ◽  
Pulsed Radiofrequency Treatment ◽  
Number Of Patients ◽  
Stimulation Of

Background: Patients with lumbosacral radicular pain may complain of persisting pain after monopolar pulsed radiofrequency (PRF) treatment. Objective: We evaluated the effect of bipolar PRF stimulation of the dorsal root ganglion (DRG) in patients with chronic lumbosacral radicular pain who were unresponsive to both monopolar PRF stimulation of the DRG and transforaminal epidural steroid injection (TFESI). Study Design: This is a prospective observational study. Setting: The outpatient clinic of a single academic medical center in Korea. Methods: We retrospectively reviewed data from 102 patients who had received monopolar PRF to the DRG for management of lumbosacral radiculopathy. Of these, 32 patients had persistent radicular pain that was scored at least 5 on a numeric rating scale (NRS). Twenty-three of them were included in this study and underwent bipolar PRF of the DRG. The outcomes after the procedure were evaluated using the NRS for radicular pain before treatment and 1, 2, and 3 months after treatment. Successful pain relief was defined as ≥ 50% reduction in the NRS score compared with the score prior to treatment. Furthermore, at 3 months after treatment, patient satisfaction levels were examined. Patients reporting very good (score = 7) or good results (score = 6) were considered to be satisfied with the procedure. Results: The NRS scores changed significantly over time. At 1, 2, and 3 months after bipolar PRF, the NRS scores were significantly reduced compared with the scores before the treatment. Twelve (52.2%) of the 23 patients reported successful pain relief and were satisfied with treatment results 3 months after bipolar PRF. No serious adverse effects were recorded. Limitations: A small number of patients were recruited and we did not perform long-term follow-up. Conclusion: We believe the use of bipolar PRF of the DRG can be an effective and safe interventional technique for chronic refractory lumbosacral radiculopathy. It appears to be a potential option that can be tried before proceeding to spinal surgery. Key words: Bipolar, pulsed radiofrequency, lumbosacral radicular pain, chronic pain, dorsal root ganglion, spinal stenosis, herniated disc

scholarly journals Mechanism of dorsal root ganglion stimulation for pain relief in painful diabetic polyneuropathy is not dependent on GABA release in the dorsal horn of the spinal cord

2019 ◽  
Vol 26 (1) ◽  
pp. 136-143 ◽  
Author(s):  
Eva Koetsier ◽  
Glenn Franken ◽  
Jacques Debets ◽  
Lonne Heijmans ◽  
Sander M.J. Kuijk ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pain Relief ◽  
Dorsal Root Ganglion ◽  
Dorsal Horn ◽  
Dorsal Root ◽  
Diabetic Polyneuropathy ◽  
Gaba Release

scholarly journals Retrospective analysis of complications associated with dorsal root ganglion stimulation for pain relief in the FDA MAUDE database

2019 ◽  
Vol 44 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Eellan Sivanesan ◽  
Mark C Bicket ◽  
Steven P Cohen
Keyword(s):  
Pain Relief ◽  
Dorsal Root Ganglion ◽  
Adverse Events ◽  
Dorsal Root ◽  
New Technology ◽  
Safety Data ◽  
Secondary Analysis ◽  
Freedom Of Information ◽  
Serious Adverse Events ◽  
Innovative Therapy

Background and objectivesDorsal root ganglion stimulation is an emerging therapy in the treatment of chronic pain. Compared with traditional spinal cord stimulation, it allows a discretely targeted stimulation profile and may act via differing mechanisms of action. Despite these advantages, little is known about the complications associated with this new modality.MethodsWe queried the MAUDE (Manufacturer and User Facility Device Experience) database for all entries named ‘Dorsal root ganglion stimulator for pain relief’ reported between May 1, 2016 and December 31, 2017. We verified these data through the Office of the Freedom of Information Act at the US Food and Drug Administration. We then eliminated duplicate entries and categorized each complication based on the event description. A secondary analysis was performed to characterize the serious adverse events and the severity of new neurologic symptoms and infections.ResultsWe identified 979 unique episodes following our process of deduplication. Almost half (47%) of entries were categorized as device-related complications, a quarter (28%) as procedural complications, with the remainder as patient complaints (12%), serious adverse events (2.4%), and ‘other’ complications (4.6%). The majority of complications were managed surgically with revision (n = 488; 49.8%) rather than explant (n = 161; 16.4%) events, respectively.ConclusionsThe ‘Dorsal root ganglion stimulator for pain relief’ device has been publicized as a breakthrough in neuromodulation technologies. As with any new technology, we must proceed with caution and re-evaluate effectiveness as information becomes available. The MAUDE database has provided safety data unique for this device that will aid in informed consent and further refinement of this innovative therapy.

scholarly journals Dorsal Root Ganglion Stimulation Modulates Cortical Gamma Activity in the Cognitive Dimension of Chronic Pain

2020 ◽  
Vol 10 (2) ◽  
pp. 95 ◽  
Author(s):  
Tariq Parker ◽  
Yongzhi Huang ◽  
Ashley L.B. Raghu ◽  
James J. FitzGerald ◽  
Alexander L. Green ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Working Memory ◽  
Pain Relief ◽  
Dorsal Root Ganglion ◽  
Task Performance ◽  
Dorsal Root ◽  
Oscillatory Activity ◽  
Cognitive Dimension ◽  
Gamma Power ◽  
Back Task

A cognitive task, the n-back task, was used to interrogate the cognitive dimension of pain in patients with implanted dorsal root ganglion stimulators (DRGS). Magnetoencephalography (MEG) signals from thirteen patients with implanted DRGS were recorded at rest and while performing the n-back task at three increasing working memory loads with DRGS-OFF and the task repeated with DRGS-ON. MEG recordings were pre-processed, then power spectral analysis and source localization were conducted. DRGS resulted in a significant reduction in reported pain scores (mean 23%, p = 0.001) and gamma oscillatory activity (p = 0.036) during task performance. DRGS-induced pain relief also resulted in a significantly reduced reaction time during high working memory load (p = 0.011). A significant increase in average gamma power was observed during task performance compared to the resting state. However, patients who reported exacerbations of pain demonstrated a significantly elevated gamma power (F(3,80) = 65.011612, p < 0.001, adjusted p-value = 0.01), compared to those who reported pain relief during the task. Our findings demonstrate that gamma oscillatory activity is differentially modulated by cognitive load in the presence of pain, and this activity is predominantly localized to the prefrontal and anterior cingulate cortices in a chronic pain cohort.

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