High-Frequency Spinal Cord Stimulation Beneficial for Painful Diabetic Neuropathy
High-frequency spinal cord stimulation (SCS) may provide pain relief and neurologic improvement for patients with painful diabetic neuropathy (PDN), according to a study presented at the American Academy of Neurology’s 75th Annual Meeting from April 22 to 27 in Boston, MA and live online. After 6 months, study participants who received high-frequency SCS reported a 76% decrease in their average amount of pain, while the group who received conventional medical management (CMM) had a 2% increase in their average amount of pain experienced. After 2 years, those who received high-frequency SCS reported 80% improvement in their average amount of pain and 66% receiving this therapy continued to have improvements in clinician-assessed neurologic function.
The study involved 216 participants who had PDN symptoms for at least 1 year that were not responding to medications. Half of the people received 10 kHz SCS plus CMM for 6 months, and half received only CMM. At 6 months, people had the option to switch to the other treatment. The participants were followed for a total of 2 years.
In tests of their motor function, sensation, and reflexes, improvements were seen in 62% of those receiving SCS compared to 3% of those receiving only CMM. A total of 93% of those receiving only CMM and eligible to cross over chose to receive SCS after 6 months, while none of those receiving SCS wanted to receive CMM only.
“This study demonstrates that high-frequency stimulation provides long-term pain relief with acceptable safety,” said Erika Petersen, MD, University of Arkansas in Little Rock. “The improvements in motor function, sensation, and reflexes suggest that this therapy could have disease-modifying potential. Confirmation of results through studies in larger groups of people could further strengthen our understanding of this spinal cord stimulation therapy for the treatment of painful diabetic neuropathy.”
Petersen also noted that high-frequency stimulation appears to provide greater pain relief than low-frequency stimulation. Also, high-frequency stimulation does not create the “pins and needles” sensation that comes with low-frequency stimulation.