QST and PET Targeted SCS
Research type
Research Study
Full title
A prospective open label pilot study to investigate and characterize peripheral and central sensitisation changes and dynamic brain imaging in patients with lumbar radiculopathy and intractable neuropathic pain (without previous spinal surgery) routinely treated with targeted Spinal cord stimulation.
IRAS ID
180398
Contact name
Vivek Mehta
Contact email
Sponsor organisation
Research & Development Operations Manager, Joint Research Management Office
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
Targeted Spinal Cord Stimulation (SCS) is an effective therapy and is offered as a standard care for complex, long lasting painful conditions. This treatment is routinely used as per NICE guideline TA159.
Several theories have been put forward to explain the mechanism of action of SCS. But the exact mechanism and the changes in the pain pathway are still not clear. Previous research in patients with long standing pain suggests increased sensitivity of the pain pathway and also changes in specific areas of the brain. Our preliminary audit shows that a successful implantation of the SCS reverses the sensitivity of the pain pathway.
Targeted SCS at L2 with the Axium SCS system has the potential of augmenting the neural signaling for spinal pain and hence changes in central sensitisation. This remains to be characterised. This study will aim to characterise the changes in the peripheral and central sensitisation in the pain pathway and also look at dynamic brain imaging. This will involve special tests looking at the sensitivity of the nervous system to various stimuli including touch, pressure and temperature. Special scan called Positron Emission Tomography (PET) CT will be obtained to look at the brain activity. These tests will be used in conjunction with standard questionnaires, which are routinely used to look at pain levels, quality of life and mood. By doing these tests before and after the insertion of the targeted SCS we hope to recognise a pattern of change which will correlate with an improvement in pain levels.
A total of 10 patients undergoing a targeted SCS at L2 level with the Axium SCS system will be recruited for this study.
REC name
London - London Bridge Research Ethics Committee
REC reference
15/LO/1667
Date of REC Opinion
12 Jan 2016
REC opinion
Further Information Favourable Opinion