Benefits of high-frequency spinal cord stimulation for painful diabetic peripheral neuropathy

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Created On: 09/01/2024

This prospective cohort study aimed to investigate whether individuals with painful diabetic peripheral neuropathy (PDN), treated with high-frequency spinal cord stimulation (SCS), experience enhancements in peripheral nerve function in the lower extremities.

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Key take away

High-frequency spinal cord stimulation in patients with painful diabetic peripheral neuropathy showed promising improvements in lower-extremity pain, weakness, and sensory symptoms over a 12-month follow-up.

Background

Method

Patients diagnosed with PDN underwent treatment with high-frequency SCS and were monitored for 12 months post-implantation. Clinical outcomes, encompassing pain severity, neuropathic symptoms, and neurological function, were examined. Utilizing the quantitative sudomotor axon reflex test (QSART), the small-fiber sudomotor function was evaluated. On the other hand, large-fiber function was analyzed through nerve conduction studies. Laser doppler flowmetry was employed to estimate lower-extremity perfusion.

Result

Overall, 9 subjects completed the twelve-month follow-up and exhibited improvements in lower-extremity pain, positive sensory symptoms, and weakness. Neuropathy impairment scores showed enhancement, and two patients demonstrated recovery of sensory responses in nerve conduction studies. A decrease in sweat volume was observed in the proximal leg during the QSART, while no such reduction occurred at other locations. No profound differences were reported in lower-extremity perfusion or nerve conduction studies compared to baseline.

Conclusion

The alleviation of pain corresponded with improvements in neuropathy symptoms. While this study offered promising initial data supporting the hypothesis of a positive impact of SCS on peripheral neuropathy, the findings were based on a small sample size and necessitated additional investigations.