By employing an implanted device to modify or block nerve activity to alleviate the sensation of pain reaching the brain, a spinal cord stimulation (SCS) is most often performed after nonsurgical pain treatment procedures have failed to provide adequate relief.
In a new study published in the journalBioelectronic Medicine on April 28, 2022, a research team based in the University of California San Diego School of Medicine showed that high-frequency SCS was more effective in perceived pain reduction (PPR) than low-frequency SCS in patients who were examined, and that there was some variation in PPR between male and female patients.
In 1989, the FDA approved high-frequency SCS (10,000 Hz) as a therapy for chronic back and leg pain. In 2015, the FDA approved high-frequency SCS, which has lowered its duration, reduced in amplitude, and does not cause paresthesia, or an abnormal sensation of tingling or prickling.
94 patients (40 females, 54 males) who received HF-SCS and 143 patients (70 females and 73 males) who received LF-SCS were examined after undergoing SCS therapy. PPR across all patients improved at three and six months post-implantation, but HF-SCS produced greater PPR than LF-SCS. HF-SCS was also associated with decreased subsequent use of opioids to relieve pain.
There were jeopardy differences in the evidence between the sexes, however.
- Male PPR, for example, was significantly better for HF-SCS at three and six months when compared to LF-SCS, while this was only true for females at the 6 month time point.
- LF-SCS males used more opioids post-implantation and at six months while females used more opioids post-implantation, at three, six and tended to use more opiates at the 12-month time-point.
According to a growing author, sex specific immune pathways are largely associated with chronic pain processes, according to senior author Imanuel Lerman, an associate professor of anesthesiology and pain management at UC San Diego Health. Despite the observed parameter-specific differences in spinal cord stimulation effectiveness and opiate use, these findings are incredibly interesting.
It''s a first step in the right direction, but a lot of work is required to be done in order to bestize sex specific pain regulatory strategies that may be applied to specific types of neuromodulation and pharmaceutical therapies.
All of the authors are at UC San Diego, including Rosalynn R.Z. Conic, Zabrina Reyes, and Sopyda Yin, both. Jacob Caylor, UC San Diego and Northwest Pain Care, Spokane, WA, Christina L. Cui, Duke University, and Eric Nelson of the Pacific Western University of Health Sciences.