A digital tool for multidimensional assessment and prediction of treatment effectiveness in chronic pain management.

Given the multidimensional aspect of pain, the assessment of treatment efficacy is challenging. The prospective observational multicenter PREDIBACK study aimed to assess, compare, and predict the effectiveness of different treatments for persistent spinal pain syndrome type 2 (PSPS-T2) using a digital tool and the Multidimensional Clinical Response Index (MCRI) including pain intensity, functional disability, quality of life, anxiety and depression, and pain surface. Results indicated that neurostimulation was the most effective treatment at 3-, 6-, 9-, and 12-month follow-up compared to baseline, leading to significant improvements in pain, function, and quality of life, whereas optimized medical management (OMM) and spinal reoperation showed no significant benefits.

Peripheral Nerve Stimulation Implantation Combining Ultrasound With Microendoscopy for Management of Chronic Neuropathic Pain: A Case Series Study.

Background: Peripheral nerve stimulation (PNS) has emerged as a minimally invasive percutaneous procedure addressing neuropathic pain. However, the percutaneous cylindrical lead ultrasound-guided implantation procedure requires expertise that limits widespread PNS utilization. To overcome these challenges, a microinvasive endoscopy device has very recently been developed, enhancing the precision of PNS implantation by providing accurate visualization of the targeted nerve.

Virtual Reality to Improve Sleep Quality in Patients Suffering from Painful Diabetic Polyneuropathy: A Proof of Concept Study.

: Sleep disturbance is often observed in the context of chronic pain. We hypothesize that, by providing an immersive Virtual Reality (VR) experience with a serious game to chronic pain patients an hour before bedtime, attention can be diverted from the pain condition, consequently leading to improved sleep quality. The aim is to evaluate the efficacy of VR compared to usual care in reducing the number of awakenings during the night and increasing sleep efficiency in patients suffering from painful diabetic polyneuropathy (PDPN).

Successful surgical management of anterior cervical meningomyelocele associated with Klippel-Feil deformity using anterior vertebral reconstruction: a case report.

Case Report: A rare case of Klippel-Feil syndrome associated with anterior cervical meningomyelocele is reported, treated successfully using partial cervical corpectomy, spinal cord microsurgical reinsertion into the spinal canal, and vertebral reconstruction. A 71-year-old patient presented with upper limb paraesthesia, chronic neck pain, and progressive motor distal impairment. Cervical spine imaging revealed an anterior cervical meningomyelocele digging into C7 vertebra and underlying adjacent congenital fusion blocks.

Differential target multiplexed spinal cord stimulation in patients with Persistent Spinal Pain Syndrome Type II: a study protocol for a 12-month multicentre cohort study (DETECT).

Introduction: Differential target multiplexed spinal cord stimulation (DTM SCS) is a new stimulation paradigm for chronic pain management with the aim of modulating glial cells and neurons in order to rebalance their interactions. Animal studies revealed positive effects of this type of stimulation; however, studies in humans are still scarce, pointing towards the need for an evaluation of the effectiveness and safety of DTM SCS in clinical settings. Furthermore, the differential target multiplexed (DTM) algorithm consists of a combination of several programmes, which will presumably consume more energy from the spinal cord stimulation (SCS) battery.

Impact of chronic low back pain on implicit motor imagery assessed by a new laterality judgment task.

It is clear that implicit motor imagery (IMI) is impaired by chronic pain in peripheral regions (hand, feet), but unclear in axial regions (neck, shoulder, back). Previous IMI tasks displayed small-amplitude movements of axial regions, which limits person-centered IMI processes mobilization. This study aimed to assess the impact of chronic low back pain (CLBP) on IMI processes with a new task displaying large-amplitude whole-body movements mobilizing the lumbar spine.

The Opinion of Healthcare Professionals About a Proposed European Registry of Neuromodulation for Chronic Pain: An Online Survey.

Introduction: During the last decade, the complementary value of real-world data (through registries or medical records) and data from randomized clinical trials has been recognized as increasingly important. In the field of neuromodulation, only a few industry-independent nationwide neuromodulation registries are available. The interest in creating a European registry has increased but without a successful result.

Sleepiness may predict hypnotizability, while personality traits do not.

Sleepiness and personality traits have been controversially reported as associated to individual hypnotizability level i.e. receptiveness to hypnotic suggestions and behave accordingly.

Socioeconomic Determinants of Initiating Neuromodulation for Chronic Pain: A Systematic Review.

Objectives: Neuromodulation is an effective treatment for chronic pain; however, socioeconomic differences may influence decision-making to initiate this therapy. This review investigated potential differences in accessibility of neuromodulation for patients with chronic pain due to socioeconomic determinants.

Materials And Methods: Four electronic databases were used for this systematic review: MEDLINE, Embase, Scopus, and Web of Science.

Ankle torque variance is a better indicator of balance control performance than plantar perceptual sensitivity threshold.

We explored whether ankle torque variability or plantar perceptual threshold explains human balance control more effectively. We hypothesized that ankle torque variance is a better indicator of center of pressure (COP) velocity variance than plantar perceptual sensitivity. Two conditions were tested: loaded (23-kg vest added) and unloaded, as loading should diminish plantar sensitivity and increase COP velocity variability.

Improved Outcomes and Therapy Longevity after Salvage Using a Novel Spinal Cord Stimulation System for Chronic Pain: Multicenter, Observational, European Case Series.

Spinal cord stimulation (SCS) is proven to effectively relieve chronic neuropathic pain. However, some implanted patients may face loss of efficacy (LoE) over time, and conversion to more recent devices may rescue SCS therapy. Recent SCS systems offer novel stimulation capabilities, such as temporal modulation and spatial neural targeting, and can be used to replace previous neurostimulators without changing existing leads.

Gut dysbiosis in patients with chronic pain: a systematic review and meta-analysis.

Introduction: Recent evidence supports the contribution of gut microbiota dysbiosis to the pathophysiology of rheumatic diseases, neuropathic pain, and neurodegenerative disorders. The bidirectional gut-brain communication network and the occurrence of chronic pain both involve contributions of the autonomic nervous system and the hypothalamic pituitary adrenal axis. Nevertheless, the current understanding of the association between gut microbiota and chronic pain is still not clear.

Examining the Type, Quality, and Content of Web-Based Information for People With Chronic Pain Interested in Spinal Cord Stimulation: Social Listening Study.

Background: The increased availability of web-based medical information has encouraged patients with chronic pain to seek health care information from multiple sources, such as consultation with health care providers combined with web-based information. The type and quality of information that is available on the web is very heterogeneous, in terms of content, reliability, and trustworthiness. To date, no studies have evaluated what information is available about neuromodulation on the web for patients with chronic pain.

Virtual Reality for Decreasing Procedural Pain during Botulinum Toxin Injection Related to Spasticity Treatment in Adults: A Pilot Study.

Background And Objectives: Botulinum toxin injections are commonly used for the treatment of spasticity. However, injection procedures are associated with pain and procedural anxiety. While pharmacological approaches are commonly used to reduce these, innovative technology might be considered as a potential non-pharmacological alternative.

Effectiveness of Virtual Reality and Feedback to Improve Gait and Balance in Patients with Diabetic Peripheral Neuropathies: Systematic Review and Meta-Analysis.

Diabetic peripheral neuropathy (DPN) is the primary complication in patients with diabetes mellitus, characterized by loss of sensation and function in the lower limbs. Virtual reality (VR) and/or sensory feedback (FB) therapy has shown positive effects in other neurologic conditions such as stroke. However, consensus regarding their effectiveness in the DPN population is lacking.

The level of agreement between the numerical rating scale and visual analogue scale for assessing pain intensity in adults with chronic pain.

The numerical rating scale and visual analogue scale are used to quantify pain intensity. However, it has not yet been explored whether these scores are interchangeable in adults with chronic pain. Data from the prospective multicentre cross-sectional INTERVAL study were used to evaluate the one-dimensionality and agreement between numerical rating scale scores and visual analogue scale scores in adults with chronic pain.

Management of post-traumatic stress disorder symptoms by yoga: an overview.

Background: Posttraumatic stress disorder (PTSD) can occur after trauma. While PTSD management strategies include first-line pharmacotherapy and psychotherapy, mind-body therapies, such as yoga, are applied in the PTSD population. This overview aimed to summarize the effectiveness of yoga interventions on PTSD symptoms in adults in a systematic review (SR) including randomized controlled trials (RCTs).

Should we Oppose or Combine Waveforms for Spinal Cord Stimulation in PSPS-T2 Patients? A Prospective Randomized Crossover Trial (MULTIWAVE Study).

Refractory persistent spinal pain syndrome after surgery (PSPS-T2) can be successfully addressed by spinal cord stimulation (SCS). While conventional stimulation generates paresthesia, recent systems enable the delivery of paresthesia-free stimulation. Studies have claimed non-inferiority/superiority of selected paresthesia-free stimulation compared with paresthesia-based stimulation, but the comparative efficacy between different waveforms still needs to be determined in a given patient.

Mixture of longitudinal factor analyzers and their application to the assessment of chronic pain.

Multivariate longitudinal data are used in a variety of research areas not only because they allow to analyze time trajectories of multiple indicators, but also to determine how these trajectories are influenced by other covariates. In this article, we propose a mixture of longitudinal factor analyzers. This model could be used to extract latent factors representing multiple longitudinal noisy indicators in heterogeneous longitudinal data and to study the impact of one or several covariates on these latent factors.

Evaluation of External Trigeminal Nerve Stimulation to Prevent Cerebral Vasospasm after Subarachnoid Hemorrhage Due to Aneurysmal Rupture: A Randomized, Double-Blind Proof-of-Concept Pilot Trial (TRIVASOSTIM Study).

Cerebral vasospasm remains the most frequent and devastating complication after subarachnoid aneurysmal hemorrhage because of secondary cerebral ischemia and its sequelae. The underlying pathophysiology involves vasodilator peptide release (such as CGRP) and nitric oxide depletion at the level of the precapillary sphincters of the cerebral (internal carotid artery network) and dural (external carotid artery network) arteries, which are both innervated by craniofacial autonomic afferents and tightly connected to the trigeminal nerve and trigemino-cervical nucleus complex. We hypothesized that trigeminal nerve modulation could influence the cerebral flow of this vascular network through a sympatholytic effect and decrease the occurrence of vasospasm and its consequences.