Evidence map›Paper›PMID 31435499›Full record

ArticleBioelectronic medicine2019

Spinal cord stimulation in chronic pain: evidence and theory for mechanisms of action.

Jacob Caylor, Rajiv Reddy, Sopyda Yin, Christina Cui, Mingxiong Huang, Charles Huang, Rao Ramesh, Dewleen G Baker, Alan Simmons, Dmitri Souza and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Bioelectronic medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 111 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
111citing papers in PubMed, 5 pooled it
26.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

111 citing papers in PubMed, 5 syntheses or guidelines pooled it, 231 citations in OpenAlex.

  1. Pooled it
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  5. Implanted spinal neuromodulation interventions for chronic pain in adults.The Cochrane database of systematic reviews · 2021
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51 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 1 country.

Jacob CaylorDepartment of Anesthesiology, Center for Pain Medicine, University of California San Diego School of Medicine, La Jolla, CA, USA.
Rajiv ReddyDepartment of Anesthesiology, Center for Pain Medicine, University of California San Diego School of Medicine, La Jolla, CA, USA.
Sopyda YinDepartment of Anesthesiology, Center for Pain Medicine, University of California San Diego School of Medicine, La Jolla, CA, USA.
Christina CuiDepartment of Anesthesiology, Center for Pain Medicine, University of California San Diego School of Medicine, La Jolla, CA, USA.
Mingxiong HuangDepartment of Radiology, University of California San Diego School of Medicine, La Jolla, CA, USA.
Charles HuangDepartment of Radiology, VA San Diego Healthcare System, La Jolla, CA, USA.
Rao RameshDepartment of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, USA.
Dewleen G BakerVA Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.
Alan SimmonsVA Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.
Dmitri SouzaCenter for Pain Medicine, Western Reserve Hospital. Department of Surgery, Northeast Ohio Medical School (NEOMED), Athens, OH, USA.
Samer NarouzeCenter for Pain Medicine, Western Reserve Hospital. Department of Surgery, Northeast Ohio Medical School (NEOMED), Athens, OH, USA.
Ricardo VallejoBasic Science Research, Millennium Pain Center, Bloomington, IL, USA.
Imanuel LermanDepartment of Anesthesiology, Center for Pain Medicine, University of California San Diego School of Medicine, La Jolla, CA, USA.ORCID 0000-0002-6564-7222
University of California San Diego · USWestern Reserve Hospital · USIllinois Wesleyan University · USPalo Alto University · US

Funding

Interdisciplinary Anesthesiology Research Training ProgramT32GM121318 · NIGMS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Hemal H Patel, DAVID M ROTH · 2017 to 2026
$1.5M
Vagal nerve stimulation to probe inflammation and brain in posttraumatic stressIK2RX002920 · VA · VA SAN DIEGO HEALTHCARE SYSTEM · PI LERMAN, IMANUEL RUVIN · 2019 to 2024
–
NIGMS NIH HHS T32 GM121318RRD VA IK2 RX002920
6 · The paper itself

Abstract

Well-established in the field of bioelectronic medicine, Spinal Cord Stimulation (SCS) offers an implantable, non-pharmacologic treatment for patients with intractable chronic pain conditions. Chronic pain is a widely heterogenous syndrome with regard to both pathophysiology and the resultant phenotype. Despite advances in our understanding of SCS-mediated antinociception, there still exists limited evidence clarifying the pathways recruited when patterned electric pulses are applied to the epidural space. The rapid clinical implementation of novel SCS methods including burst, high frequency and dorsal root ganglion SCS has provided the clinician with multiple options to treat refractory chronic pain. While compelling evidence for safety and efficacy exists in support of these novel paradigms, our understanding of their mechanisms of action (MOA) dramatically lags behind clinical data. In this review, we reconstruct the available basic science and clinical literature that offers support for mechanisms of both paresthesia spinal cord stimulation (P-SCS) and paresthesia-free spinal cord stimulation (PF-SCS). While P-SCS has been heavily examined since its inception, PF-SCS paradigms have recently been clinically approved with the support of limited preclinical research. Thus, wide knowledge gaps exist between their clinical efficacy and MOA. To close this gap, many rich investigative avenues for both P-SCS and PF-SCS are underway, which will further open the door for paradigm optimization, adjunctive therapies and new indications for SCS. As our understanding of these mechanisms evolves, clinicians will be empowered with the possibility of improving patient care using SCS to selectively target specific pathophysiological processes in chronic pain.

Indexed as

BiomarkerChronic painComplex regional pain syndromeFailed back surgery syndromeMechanisms of actionNeuroinflammationNeuropathic painNeurophysiologyObjective measuresSpinal cord stimulation

Identifiers

PMID31435499
PMCPMC6703564
OpenAlexW2956912827

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.