Safety and Efficacy of Axon Therapy (SEAT Study), Utilizing Magnetic Peripheral Nerve Stimulation (mPNS) for Treatment of Neuropathic Pain

被引:1
作者
Kapural, Leonardo [1 ]
Patel, Janus [2 ]
Rosenberg, Jason Charles [3 ]
Li, Sean [4 ]
Amirdelfan, Kasra [5 ]
Bedder, Marshall [6 ,7 ]
机构
[1] Carolinas Pain Inst, Winston Salem, NC 27103 USA
[2] Atrium Hlth, Wake Forest Baptist Pain Ctr Premier, Winston Salem, NC USA
[3] South Carolina Pain & Spine Specialists, Murrels Inlet, SC USA
[4] Natl Spine & Pain Ctr, Shrewsbury, NJ USA
[5] IPM Med Grp, Walnut Creek, CA USA
[6] Charlie Norwood Vet Adm Med Ctr, Dept Surg, Pain Med Serv, Augusta, GA USA
[7] Wellstar Med Coll Georgia, Dept Psychiat & Hlth Behav, Addict Med Serv, Augusta, GA USA
关键词
neuropathic pain; noninvasive; cost effective; pain relief; neuropathy;
D O I
10.2147/JPR.S481944
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Many of the current treatments for chronic neuropathic pain have variable effectiveness and known side effects. Given the prevalence of this type of intractable pain (3-17% of general population), additional therapeutic non-invasive approaches are desired. Magnetic Peripheral Nerve Stimulation (mPNS) delivered at 0.5Hz provides an effective pain relief without side effects. The objective of this randomized, controlled, multi-site clinical trial was to compare long-term safety and efficacy of mPNS in patients with chronic, intractable, post-traumatic or post-surgical neuropathic pain to comprehensive Conventional Medical Management (CMM). Methods: A total of 65 patients with post-traumatic, post-surgical neuropathy were treated within a multicenter, randomized, clinical trial comparing the safety and effectiveness of mPNS + CMM to CMM alone. Patients were randomized 1:1 and followed through 90 days. The primary endpoint is a proportion of responders, 50% or greater reduction in pain at Day 90. The secondary endpoints included the European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L) and Patient Global Impression of Change (PGIC). Results: At 3 months, 71% of subjects were considered responders (>50% pain relief) in the mPNS + CMM group vs 13% of subjects in the CMM group. The mPNS + CMM group had a mean reduction in VAS scores at Day 90 of 3.8 points (>50% reduction), while CMM showed less than a 1-point (0.7 point) mean reduction or similar to 10% reduction (p < 0.0001). The EQ-5D-3L score increased in the mPNS + CMM study group, whereas the CMM group showed no improvement in EQ-5D-3L at Day 90. PGIC responder rates were 80.6% and 4.3% at Day 90 for mPNS + CMM and CMM groups, respectively. Conclusion: mPNS + CMM was superior to CMM in a randomized prospective study when used for treatment of post-traumatic, post-surgical neuropathy. Due to the lack of other effective non-invasive treatments for neuropathic pain, mPNS should be considered much earlier in the treatment algorithm.
引用
收藏
页码:3167 / 3174
页数:8
相关论文
共 10 条
[1]   STIMULATION OF A MYELINATED NERVE AXON BY ELECTROMAGNETIC INDUCTION [J].
BASSER, PJ ;
ROTH, BJ .
MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING, 1991, 29 (03) :261-268
[2]   Magnetic Peripheral Nerve Stimulation (mPNS) for Chronic Pain [J].
Bedder, Marshall ;
Parker, Lisa .
JOURNAL OF PAIN RESEARCH, 2023, 16 :2365-2373
[3]   How addictive are gabapentin and pregabalin? A systematic review [J].
Bonnet, U. ;
Scherbaum, N. .
EUROPEAN NEUROPSYCHOPHARMACOLOGY, 2017, 27 (12) :1185-1215
[4]   Peripherally Induced Reconditioning of the Central Nervous System: A Proposed Mechanistic Theory for Sustained Relief of Chronic Pain with Percutaneous Peripheral Nerve Stimulation [J].
Deer, Timothy R. ;
Eldabe, Sam ;
Falowski, Steven M. ;
Huntoon, Marc A. ;
Staats, Peter S. ;
Cassar, Isaac R. ;
Crosby, Nathan D. ;
Boggs, Joseph W. .
JOURNAL OF PAIN RESEARCH, 2021, 14 :721-736
[5]   Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis [J].
Finnerup, Nanna B. ;
Attal, Nadine ;
Haroutounian, Simon ;
McNicol, Ewan ;
Baron, Ralf ;
Dworkin, Robert H. ;
Gilron, Ian ;
Haanpaa, Maija ;
Hansson, Per ;
Jensen, Troels S. ;
Kamerman, Peter R. ;
Lund, Karen ;
Moore, Andrew ;
Raja, Srinivasa N. ;
Rice, Andrew S. C. ;
Rowbotham, Michael ;
Sena, Emily ;
Siddall, Philip ;
Smith, Blair H. ;
Wallace, Mark .
LANCET NEUROLOGY, 2015, 14 (02) :162-173
[6]   NEUROPATHIC PAIN: FROM MECHANISMS TO TREATMENT [J].
Finnerup, Nanna Brix ;
Kuner, Rohini ;
Jensen, Troels Staehelin .
PHYSIOLOGICAL REVIEWS, 2021, 101 (01) :259-301
[7]   Neuromodulation using ultra low frequency current waveform reversibly blocks axonal conduction and chronic pain [J].
Jones, Martyn G. ;
Rogers, Evan R. ;
Harris, James P. ;
Sullivan, Andrew ;
Ackermann, D. Michael ;
Russo, Marc ;
Lempka, Scott F. ;
McMahon, Stephen B. .
SCIENCE TRANSLATIONAL MEDICINE, 2021, 13 (608)
[8]   Transcutaneous Magnetic Stimulation (tMS) in Alleviating Post-Traumatic Peripheral Neuropathic Pain States: A Case Series [J].
Leung, Albert ;
Fallah, Amir ;
Shukla, Shivshil .
PAIN MEDICINE, 2014, 15 (07) :1196-1199
[9]   ANALYSIS OF A MODEL FOR EXCITATION OF MYELINATED NERVE [J].
MCNEAL, DR .
IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, 1976, 23 (04) :329-337
[10]   A Systematic Guideline by the ASPN Workgroup on the Evidence, Education, and Treatment Algorithm for Painful Diabetic Neuropathy: SWEET [J].
Sayed, Dawood ;
Deer, Timothy Ray ;
Hagedorn, Jonathan M. ;
Sayed, Asim ;
D'Souza, Ryan S. ;
Lam, Christopher M. ;
Khatri, Nasir ;
Hussaini, Zohra ;
Pritzlaff, Scott G. ;
Abdullah, Newaj Mohammad ;
Francio, Vinicius Tieppo ;
Falowski, Steven Michael ;
Ibrahim, Yussr M. ;
Malinowski, Mark N. ;
Budwany, Ryan R. ;
Strand, Natalie Holmes ;
Sochacki, Kamil M. ;
Shah, Anuj ;
Dunn, Tyler ;
Nasseri, Morad ;
Lee, David W. ;
Kapural, Leonardo ;
Bedder, Marshall David ;
Petersen, Erika A. ;
Amirdelfan, Kasra ;
Schatman, Michael E. ;
Grider, Jay Samuel .
JOURNAL OF PAIN RESEARCH, 2024, 17 :1461-1501