ReviewFrontiers in psychology2026
Beyond device parameters: psychological predictors of spinal cord stimulation success and their neurobiological mechanisms-a narrative review.
Review in Frontiers in psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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.
Who cites it
3 citing papers in PubMed.
- Towards Selective Trial Stimulation in Spinal Cord Stimulation: Clinical and Psychological Evidence for an Individualised Implantation Strategy.Journal of clinical medicine · 2026Review
- The Spinal Cord Stimulation Trial Success Score (STSS): A Narrative Review and Evidence-Informed Conceptual Framework for Structured Candidate Assessment.Journal of clinical medicine · 2026Review
- Long-Term Effectiveness of Spinal Cord Stimulation Beyond 24 Months: A PRISMA-ScR-Informed Scoping Review.Journal of clinical medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Spinal cord stimulation (SCS) represents an established treatment for refractory chronic pain, yet significant outcome variability persists despite technological advances. This narrative review examines why psychological factors assume central importance in neuromodulation outcomes by establishing pathophysiological contrasts between SCS and pharmacological pain management. Unlike passive pharmaceutical approaches operating through systemic biochemical modulation, SCS requires active patient engagement in device operation, expectancy management, and behavioral adaptation, creating distinct neurobiological requirements for success. Multiple psychological domains predict outcomes. Cognitive factors include pain catastrophizing (the strongest predictor), patient expectations, and cognitive control capacity. Emotional determinants encompass pre-implantation depression, anxiety, and alexithymia. Behavioral patterns such as fear-avoidance, locus of control, and coping strategies significantly influence treatment success. Neuroimaging evidence suggests that these psychological factors modulate response through alterations in prefrontal-limbic circuits, reward processing networks, and cortical reorganization. Maladaptive profiles are associated with reduced prefrontal top-down control, heightened limbic reactivity, impaired mesolimbic reward valuation, and persistent central sensitization. As a narrative synthesis prioritizing conceptual integration over quantitative aggregation, this review: (1) establishes psychological readiness as a neurobiological prerequisite rather than an administrative requirement, (2) delineates mechanisms through which catastrophizing, depression, and fear-avoidance disrupt SCS efficacy via limbic hyperactivity and impaired descending modulation, and (3) presents evidence-based optimization strategies including pre-implantation cognitive-behavioral therapy, acceptance and commitment therapy, behavioral activation, graded exposure, and digital health technologies. Future directions require standardized multidomain assessment protocols, multimodal predictive models integrating psychological phenotypes with objective biomarkers, and expanded digital therapeutics maintaining evidence-based rigor.
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Registered trials
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.