Effect of Conventional Spinal Cord Stimulation on Serum Protein Profile in Patients With Persistent Spinal Pain Syndrome: A Case-Control Study.

Autor: Fabregat-Cid G; Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain; Surgery Department, Medical School, University of Valencia, Valencia, Spain. Electronic address: gfabregat@gmail.com., Cedeño DL; SGX Medical LLC, Bloomington, IL, USA., Harutyunyan A; Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain., Rodríguez-López R; Department of Clinical Analysis, University General Hospital, Valencia, Spain., Monsalve-Dolz V; Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain., Mínguez-Martí A; Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain., Hernández-Cádiz MJ; Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain., Escrivá-Matoses N; Clinic University Hospital, Valencia, Spain., Villanueva-Pérez V; Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain., Asensio Samper JM; Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain; Surgery Department, Medical School, University of Valencia, Valencia, Spain., De Andrés J; Multidisciplinary Pain Management Department, University General Hospital, Valencia, Spain; Surgery Department, Medical School, University of Valencia, Valencia, Spain., Vallejo R; SGX Medical LLC, Bloomington, IL, USA.
Jazyk: angličtina
Zdroj: Neuromodulation : journal of the International Neuromodulation Society [Neuromodulation] 2023 Oct; Vol. 26 (7), pp. 1441-1449. Date of Electronic Publication: 2023 Jul 28.
DOI: 10.1016/j.neurom.2023.05.004
Abstrakt: Background: Spinal cord stimulation (SCS) provides pain relief for most patients with persistent spinal pain syndrome type 2 (PSPS 2). Evidence is mounting on molecular changes induced by SCS as one of the mechanisms to explain pain improvement. We report the SCS effect on serum protein expression in vivo in patients with PSPS 2.
Materials and Methods: Serum proteins were identified and quantified using mass spectrometry. Proteins with significantly different expression among patients with PSPS 2 relative to controls, responders, and nonresponders to SCS, or significantly modulated by SCS relative to baseline, were identified. Those most correlated with the presence and time course of pain were selected using multivariate discriminant analysis. Bioinformatic tools were used to identify related biological processes.
Results: Thirty patients with PSPS 2, of whom 23 responded to SCS, were evaluated, together with 14 controls with no pain who also had undergone lumbar spinal surgery. A significant improvement in pain intensity, disability, and quality of life was recorded among responders. Five proteins differed significantly at baseline between patients with PSPS 2 and controls, with three proteins, mostly involved in immune processes and inflammation, being downregulated and two, mostly involved in vitamin metabolism, synaptic transmission, and restorative processes, being upregulated. In addition, four proteins, mostly related to immune processes and inflammation, decreased significantly, and three, mostly related to iron metabolism and containment of synaptic sprouting, increased significantly during SCS.
Conclusion: This study identifies various biological processes that may underlie PSPS 2 pain and SCS therapeutic effects, including the modulation of neuroimmune response and inflammation, synaptic sprouting, vitamin and iron metabolism, and restorative processes.
(Copyright © 2023 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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