Selective L4 Dorsal Root Ganglion Stimulation Evokes Pain Relief and Changes of Inflammatory Markers: Part I Profiling of Saliva and Serum Molecular Patterns
Autor: | Birgit Stoffel-Wagner, René Hurlemann, Sascha Gravius, Anna Weidlich, Christian Maier, Thomas L. Yearwood, Jeffery M. Kramer, Shafqat Rasul Chaudhry, Krishnan Chakravarthy, Johannes Kruppenbacher, Philipp Westhofen, Sajjad Muhammad, Thomas M. Randau, Nadine Gravius, Azize Boström, Dirk Scheele, Thomas M. Kinfe |
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Rok vydání: | 2019 |
Předmět: |
Male
Saliva medicine.medical_specialty Electric Stimulation Therapy Stimulation Inflammation Gastroenterology 03 medical and health sciences 0302 clinical medicine Dorsal root ganglion Ganglia Spinal Internal medicine medicine Humans Pain Management Aged business.industry Leptin Interleukin General Medicine Middle Aged medicine.disease Anesthesiology and Pain Medicine Complex regional pain syndrome medicine.anatomical_structure Neurology Neuropathic pain Neuralgia Female Neurology (clinical) medicine.symptom business Biomarkers Complex Regional Pain Syndromes 030217 neurology & neurosurgery |
Zdroj: | Neuromodulation: Technology at the Neural Interface. 22:44-52 |
ISSN: | 1094-7159 |
DOI: | 10.1111/ner.12866 |
Popis: | Objectives Complex regional pain syndrome (CRPS) and associated comorbidities have been linked to a pro-inflammatory state driven by different mediators. Targeted dorsal root ganglion stimulation (DRGSTIM ) suppressed pain levels and improved functional capacity in intractable CRPS. However, clinical trials assessing the impact of DRG stimulation on the neuroimmune axis are lacking. Methods This study enrolled 24 subjects (12 refractory CRPS patients plus suitably matched healthy controls) and performed immunoassays of inflammatory mediators in saliva and serum along with score-based assessments of pain, mood, and sleep quality at baseline and after three months of selective L4-DRGSTIM . Results After three-month L4-DRGSTIM CRPS associated pain significantly decreased. In addition, disturbed sleep and mood improved post-DRGSTIM , although statistically not significant. Significantly increased serum values of pro-inflammatory markers were detected pre- and post L4-DRGSTIM for high-mobility group box 1, tumor-necrosis factor α, interleukin (IL) 6, and leptin. IL-1β was significantly elevated pre-L4 DRGSTIM , but not posttreatment. Elevated anti-inflammatory IL-10 significantly decreased after three months in serum, while saliva oxytocin concentrations increased in CRPS subjects after L4-DRGSTIM (p = 0.65). No severe implantation and stimulation associated adverse events were recorded. Conclusions Selective L4-DRGSTIM improved neuropathic pain and functional impairment in CRPS as previously reported. CRPS patients displayed a pro-inflammatory molecular pattern in serum. Serum anti-inflammatory IL-10 significantly declined, while saliva oxytocin nonsignificantly increased after L4-DRGSTIM . An evidence-based relational interpretation of our study is limited due to the uncontrolled study design. However, molecular profiling of biofluids (saliva, serum) represents a novel and experimental field in applied neuromodulation, which warrant further investigations to unveil mechanisms of neuroimmune modulation. |
Databáze: | OpenAIRE |
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