Results: Frequency response curves showed an inverse relationship between stimulation sensation strength and ECAP amplitude, with higher frequencies generating smaller ECAPs but stronger stimulation-induced paraesthesia (at constant stimulation amplitude). During the experiments subjects were asked to rate the stimulation-induced sensation (paraesthesia) on a scale from 0 to 10. Stimulation was performed at various vertebral levels, varying the frequency (ranging from 2 to 455 Hz) while all other stimulating variables were kept constant. Neurophysiological recordings were taken during the patient’s trial phase at two routine follow-ups using a custom external stimulator capable of recording ECAPs in real-time from all non-stimulating contacts. Both lead together thus spanning about three vertebral levels. Patients were implanted according to standard practice, having two 8-contact leads (8 mm inter-electrode spacing) which overlapped 2–4 contacts around the T9/T10 interspace. Methods: Patients suffering with chronic neuropathic lower-back and/or lower-limb pain undergoing an epidural SCS trial were recruited. This study investigates the effect of stimulus frequency on both the ECAP amplitude as well as the perceived stimulus sensation in patients undergoing SCS therapy for chronic back and/or leg pain. ECAP amplitude grows linearly with stimulus current after a threshold, and a larger ECAP results in a stronger stimulus sensation for patients. Thomas’ NHS Foundation Trust, London, United Kingdomīackground: The effect of spinal cord stimulation (SCS) amplitude on the activation of dorsal column fibres has been widely studied through the recording of Evoked Compound Action Potentials (ECAPs), the sum of all action potentials elicited by an electrical stimulus applied to the fibres. 1Saluda Medical Pty Ltd., Artarmon, NSW, Australia.Parker 1 Dave Mugan 1 Adnan Al-Kaisy 2 Stefano Palmisani 2* Springer, Berlin Heidelberg New York Tokyo.Gerrit Eduard Gmel 1 Rosana Santos Escapa 1 John L. Zimmermann M (1975) Neurophysiological models for nociception, pain and pain trerapy. Shatin D, Mullet K, Hults G (1986) Totally implantable spinal cord stimulation for chronic pain: disain and efficiency. Richardson R, Signeira E, Cerullo L (1979) Spinal epidural neurostimulation for treatment of acute and chronic intractable pain: initial and long term results. Its diagnosis and treatment by spinal cord stimulation. Surg Neurol 4: 148–152ĭe La Porte Ch, Siegfried J (1983) Lumbosacral spinal fibrosis (spinal arachnoiditis). Nielson KD, Adams JE, Hosobuchi Y (1975) Experience with dorsal column stimulation for relief of chronic intractable pain. Nashold BS, Friedman H (1972) Dorsal column stimulation for control of pain. Halter J, Dolenc V, Dimitrijevic MR, Sharkey PC (1983) Neurophysiological assessment of electrode placement in the spinal cord. In Bonica JJ et al (eds) Advances in pain research and therapy. Appl Neurophysiol 46: 245–253Įrikseo DL, Long DM (1983) Ten years follow-up of dorsal column stimulation. Neurochirurgia 27: 47–50ĭimitrijevic MR, Faganet J, Sherwood AM (1983) Spinal cord stimulation as a tool for physiological research. Appl Neurophysiol 44: 160–170ĭemirel T, Braun W, Reimes CD (1984) Results of spinal cord stimulation in patients suffering from chronic pain a two year observation period. Davis R, Gray E (1981) Technical factors important to dorsal column stimulation.
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