Abstract Details

Title Homo- and Heterotopic Analgesic Effects of Maximal Non-Invasive High Voltage Electrical Stimulation of Lumbo-Sacral Nerve Roots

Topic Ethics, Pain and Palliative Care

Presentation(s) S17 - (-)

Poster/Presentation
Number 003

Objective

Background DNIC is usually studied by measuring the pain intensity for a test stimulus before and during or after the application of a noxious conditioning stimulus. Recent use of non-invasive high voltage electrical stimulation (HVES) of lumbosacral roots (LS) in patients with degenerative spine disorders (Troni et al., 2012, Clin Neurophysiol; in press), unexpectedly revealed transient homotopic analgesic effects on back and radicular pain. The aim of our study was to verify if LS-HVES also induces heterotopic analgesic effects.

Design/Methods LS-HVES was performed in 15 patients (44 to 76 ys) suffering from nociceptive or mixed painful conditions of the upper limbs (elbow or shoulder osteoarthritis, cervical radiculopathy etc.), in whom LS-HVES was advised as a diagnostic tool for concomitant various neurological conditions. LS-HVES was performed according to the method described by Troni et al., (2011) which allows reaching supramaximal stimulation of nerve roots near to their origin from the spinal cord. No more then 3 to 5 supramaximal stimuli were delivered (Digitimer D185) in rapid sequence with maximum current strength not exceeding 1 A. Pain was evaluated with the BS-11 verbal score in basal condition and monitored after LS-HVES until the disappearance of any detectable effects.

Results In all patients LS-HVES immediately induced a clear-cut pain remission with a reduction of BS-11 score by 50 to 70 % and the effects lasted, with a progressively fading course, 2 to 6 hours. In all patients HVES was well tolerated and no side effects were reported.

Conclusions As indirectly compared to other techniques described so far, the time course and duration of the heterotopic analgesic effects observed in this study strongly suggests that LS-HVES is a powerful tool to activate the endogenous DNIC system.

Authors/Disclosures
Valter Troni, MD (Ospedale San Luigi Gonzaga) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
David Vaillancourt	David Vaillancourt has received personal compensation for serving as an employee of Automated Imaging Diagnostics. David Vaillancourt has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. The institution of David Vaillancourt has received research support from NIH. David Vaillancourt has received intellectual property interests from a discovery or technology relating to health care.

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