In patients with unbearable chronic neuropathic pain who have insufficient effect of conventional pain treatment spinal cord stimulation (SCS) is an option. It is a well-established clinical method in which an electrode is placed in the epidural space that gives pulses to the spinal cord. Since years these pulses are given tonically at for example 40 Hz. If correctly placed this causes a tingling sensation covering the painful area. In many patients this gives clinical relevant pain suppression. However a new stimulation protocol in which the spinal cord is stimulated by short bursts of pulses (500 Hz) is developed. It is claimed that in this way no paresthesias are felt while it keeps its pain suppressive effect. From both protocols much of the working mechanism is unknown, although it is expected to have effects on both the spinal cord and the brain.
In the Medical Spectrum Twente this year about 40 patients who already have (tonic) SCS will get the new burst stimulation protocol to test it for two weeks and to study the clinical effects of burst. I participate in this study. In these patients also EEG, and somatosensory and pain evoked potentials will be measured in the cases that they have tonic, burst and no stimulation. In my study I focus on the effect of SCS on the processing of pain and cortical (pain) networks. Together with Cecile the Vos also the effect of pain and spinal cord stimulation on somatosensory evoked potentials will be studied.
This graduation project is part of the PHD project of Cecile de Vos.
Ir. C.C. de Vos (Medisch Spectrum Twente and University of Twente)
Prof. dr. ir. M.J.A.M. van Putten (Medisch Spectrum Twente and University of Twente)