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Article ; Online: Spinal cord stimulation in painful diabetic neuropathy: An overview.

Petersen, Erika A

2024 Volume 206 Suppl 1, Page(s) 110760

Abstract: Up to 25% of people with diabetes develop painful diabetic neuropathy (PDN). The standard of care pharmacotherapies for PDN have limited efficacy with a considerable side effect profile. Spinal cord stimulation (SCS) is a form of electrical ... ...

Abstract	Up to 25% of people with diabetes develop painful diabetic neuropathy (PDN). The standard of care pharmacotherapies for PDN have limited efficacy with a considerable side effect profile. Spinal cord stimulation (SCS) is a form of electrical neurostimulation that modulates neural function via electrodes implanted into the spinal epidural space. While low frequency SCS has been shown to be potentially effective for treating pain associated with neuropathies, it masks pain perception by inducing paresthesia. Compared to low frequency SCS, high frequency (10 kHz) SCS delivers paresthesia-free therapy. As was shown in a randomized controlled trial, SENZA-PDN (NCT03228420), 10 kHz SCS is safe and effective for the treatment of painful diabetic neuropathy. 10 kHz SCS offered a comprehensive treatment that improved pain levels, sleep, quality of life, and neurological function. These improvements correlated with a high degree of patient satisfaction. 10 kHz SCS provides a safe, durable and effective treatment for PDN with the unique potential to improve neurological function. In patients for whom durable, effective treatments have been limited thus far, the findings of the SENZA-PDN study are encouraging.
MeSH term(s)	Humans ; Diabetes Mellitus ; Diabetic Neuropathies/therapy ; Pain ; Pain Management ; Quality of Life ; Spinal Cord Stimulation ; Treatment Outcome ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2024-01-20
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	632523-3
ISSN	1872-8227 ; 0168-8227
ISSN (online)	1872-8227
ISSN	0168-8227
DOI	10.1016/j.diabres.2023.110760
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Article ; Online: Impedance trend from a symptomatic perielectrode cystic cavity following deep brain stimulation: illustrative case.

Elberson, Brooke / Scott, Hayden / Dhall, Rohit / Petersen, Erika

Journal of neurosurgery. Case lessons

2023 Volume 6, Issue 12

Abstract: Background: Deep brain stimulation (DBS) is a well-established neurosurgical intervention for a growing number of neurological and psychiatric diseases. Patients who are affected by Parkinson's disease may benefit from DBS of either the subthalamic ... ...

Abstract	Background: Deep brain stimulation (DBS) is a well-established neurosurgical intervention for a growing number of neurological and psychiatric diseases. Patients who are affected by Parkinson's disease may benefit from DBS of either the subthalamic nucleus or the globus pallidus internus. Patients who undergo DBS often notice a significant reduction in their clinical symptoms; however, the procedure is not without risks. Multicenter studies have reported postoperative complications such as hardware infection, intracranial hemorrhage, and perielectrode edema. Observations: The authors report a case of a perielectrode cyst managed conservatively. Tracking the impedance trend was a novel approach to monitor for changes within the cyst and to herald a clinical change in the patient. Perielectrode cystic formation can be a transient process that resolves spontaneously or with conservative, nonoperative management, and all diagnostic information is valuable in making clinical decisions. Lessons: Impedance values have provided an appropriate estimation of this patient's clinical picture. The authors suggest treatment of edema and a cyst after DBS lead implantation through conservative management and observation, avoiding the removal of hardware if a patient's clinical picture is either stable or improving and forgoing additional clinical imaging if the impedance values are trending in an appropriate direction.
Language	English
Publishing date	2023-09-18
Publishing country	United States
Document type	Journal Article
ISSN	2694-1902
ISSN (online)	2694-1902
DOI	10.3171/CASE23349
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Article ; Online: Experience of loneliness and depression due to spousal separation in long-term care residents and their spouses: a qualitative systematic review protocol.

Robertson, Madison A / Petersen, Erika E / Ross-White, Amanda / Egan, Rylan

JBI evidence synthesis

2023 Volume 21, Issue 8, Page(s) 1672–1678

Abstract: Objective: The objective of this review is to describe the experience of loneliness and/or depression due to spousal separation when one or both spouses are admitted into a long-term care facility.: Introduction: Loneliness and depression are ... ...

Abstract	Objective: The objective of this review is to describe the experience of loneliness and/or depression due to spousal separation when one or both spouses are admitted into a long-term care facility. Introduction: Loneliness and depression are important concerns for the health and well-being of older adults separated from their spouses due to long-term care placement. Social relationships, specifically spousal relationships, have a significant impact on the mental health of older adults. However, there is limited research on the experience or effect of spousal separation on long-term care residents' and their spouses' experience of loneliness and/or depression. Inclusion criteria: This review will include long-term care residents and their spouses who are over the age of 50 and have a spouse they are separated from due to long-term care placement. Studies will be included in this review if they explore the experiences of loneliness and/or depression due to spousal separation with one or both spouses living in a long-term care facility. Methods: This review will be conducted in line with the JBI methodology for systematic reviews of qualitative evidence. MEDLINE was used for the initial search. A full search strategy was then developed for MEDLINE, CINAHL, Embase, and PsycINFO. The JBI approach to study selection, critical appraisal, data extraction, data synthesis, and assessment of confidence will be used. Two reviewers will pilot test the screening criteria and data extraction protocol. Review registration: PROSPERO CRD42022333014.
MeSH term(s)	Humans ; Aged ; Loneliness/psychology ; Spouses/psychology ; Long-Term Care ; Depression/epidemiology ; Systematic Reviews as Topic ; Review Literature as Topic
Language	English
Publishing date	2023-08-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2689-8381
ISSN (online)	2689-8381
DOI	10.11124/JBIES-22-00270
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Article ; Online: Glioblastoma, IDH-Wildtype, CNS WHO Grade 4, Associated with Deep Brain Stimulation in a Patient with Essential Tremor: Report of a Case with Molecular Characterization, and Review of the Literature.

Burns, Jennie / Guley, Natalie / Gokden, Murat / Petersen, Erika / Virmani, Tuhin

Movement disorders clinical practice

2023 Volume 10, Issue 3, Page(s) 526–528

Language	English
Publishing date	2023-02-16
Publishing country	United States
Document type	Journal Article
ISSN	2330-1619
ISSN (online)	2330-1619
DOI	10.1002/mdc3.13672
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Article: Painful Peripheral Neuropathies of the Lower Limbs and/or Lower Extremities Treated with Spinal Cord Stimulation: A Systematic Review with Narrative Synthesis.

Burkey, Adam R / Chen, Jeffrey / Argoff, Charles E / Edgar, Deborah R / Petersen, Erika A

Journal of pain research

2023 Volume 16, Page(s) 1607–1636

Abstract: Introduction: Painful peripheral neuropathy (PPN) is a debilitating condition with varied etiologies. Spinal cord stimulation (SCS) is increasingly used when conservative treatments fail to provide adequate pain relief. Few published reviews have ... ...

Abstract	Introduction: Painful peripheral neuropathy (PPN) is a debilitating condition with varied etiologies. Spinal cord stimulation (SCS) is increasingly used when conservative treatments fail to provide adequate pain relief. Few published reviews have examined SCS outcomes in all forms of PPN. Methods: We conducted a systematic review of SCS in PPN. The PubMed database was searched up to February 7th, 2022, for peer-reviewed studies of SCS that enrolled PPN patients with pain symptoms in their lower limbs and/or lower extremities. We assessed the quality of randomized controlled trial (RCT) evidence using the Cochrane risk of bias tool. Data were tabulated and presented narratively. Results: Twenty eligible studies documented SCS treatment in PPN patients, including 10 kHz SCS, traditional low-frequency SCS (t-SCS), dorsal root ganglion stimulation (DRGS), and burst SCS. In total, 451 patients received a permanent implant (10 kHz SCS, n=267; t-SCS, n=147; DRGS, n=25; burst SCS, n=12). Approximately 88% of implanted patients had painful diabetic neuropathy (PDN). Overall, we found clinically meaningful pain relief (≥30%) with all SCS modalities. Among the studies, RCTs supported the use of 10 kHz SCS and t-SCS to treat PDN, with 10 kHz SCS providing a higher reduction in pain (76%) than t-SCS (38-55%). Pain relief with 10 kHz SCS and DRGS in other PPN etiologies ranged from 42-81%. In addition, 66-71% of PDN patients and 38% of nondiabetic PPN patients experienced neurological improvement with 10 kHz SCS. Conclusion: Our review found clinically meaningful pain relief in PPN patients after SCS treatment. RCT evidence supported the use of 10 kHz SCS and t-SCS in the diabetic neuropathy subpopulation, with more robust pain relief evident with 10 kHz SCS. Outcomes in other PPN etiologies were also promising for 10 kHz SCS. In addition, a majority of PDN patients experienced neurological improvement with 10 kHz SCS, as did a notable subset of nondiabetic PPN patients.
Language	English
Publishing date	2023-05-18
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2495284-9
ISSN	1178-7090
ISSN	1178-7090
DOI	10.2147/JPR.S403715
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Article: Lack of Neuromodulation Knowledge Among Rural Family Medicine Residents: A Call for Implementation Research.

Goree, Johnathan H / Hayes, Corey / Petersen, Erika / Curran, Geoffrey

Journal of pain research

2022 Volume 15, Page(s) 1183–1189

Abstract: Objective: Spinal cord stimulation is a proven, evidence-based therapy for persistent spinal pain syndrome. While some patients with this disease are managed by chronic pain physicians, many are managed in primary care offices. Despite mounting evidence, ...

Abstract	Objective: Spinal cord stimulation is a proven, evidence-based therapy for persistent spinal pain syndrome. While some patients with this disease are managed by chronic pain physicians, many are managed in primary care offices. Despite mounting evidence, dissemination of this research outside of neuromodulation related fields and implementation of this treatment in common practice has not yet occurred. We hypothesize that family medicine residents in rural training programs will have little knowledge of neuromodulation despite it being an evidence-based and common treatment of post-laminectomy syndrome. Materials and methods: Online surveys were sent to family medicine residents in six rural family medicine training programs at the University of Arkansas for Medical Sciences Regional Programs to characterize knowledge of neuromodulation as a treatment for post-laminectomy syndrome. Results: Forty-one percent of responding rural, Arkansas family medicine residents reported treating post-laminectomy syndrome during their training, yet only 10% have referred a patient for neuromodulation consultation. Residents rated their knowledge of neuromodulation/spinal cord stimulation at 19 on a scale of 0 (no knowledge) to 100 (extensive knowledge). Conclusion: Despite proof that neuromodulation is an evidence-based treatment for post-laminectomy/failed back syndrome, rural family medicine residents have limited knowledge about the therapy and many do not consider a referral for neuromodulation. Further research to ascertain effective implementation strategies to increase the uptake of neuromodulation for patients with post-laminectomy syndrome is desperately needed.
Language	English
Publishing date	2022-04-21
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2495284-9
ISSN	1178-7090
ISSN	1178-7090
DOI	10.2147/JPR.S356416
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Article: Education and Experience in Intrathecal Drug Delivery Systems (IDDS) During Pain Medicine Fellowships.

Mahmoud, Ammar / Aman, Mansoor M / Trumbo, Jennifer L / Paracha, Umera / Langell, Ashley / Petersen, Erika

Journal of pain research

2023 Volume 16, Page(s) 4367–4377

Abstract: Objective: Targeted drug delivery (TDD) via intrathecal drug delivery systems (IDDS) exposure and clinical adoption remains low despite multiple well-designed trials that demonstrate safety, efficacy, reliability, and cost-saving benefits. This study ... ...

Abstract	Objective: Targeted drug delivery (TDD) via intrathecal drug delivery systems (IDDS) exposure and clinical adoption remains low despite multiple well-designed trials that demonstrate safety, efficacy, reliability, and cost-saving benefits. This study aims to understand the possible contributing factors starting with Pain Medicine fellowship training. Materials and methods: An internet-based, anonymous pilot survey was distributed to pain medicine fellows enrolled in an Accreditation Council for Graduate Medical Education (ACGME) accredited pain medicine training program during the 2021-2022 academic year. Fellowship programs were identified using published online ACGME accreditation data. The survey was distributed via email to fellowship program directors and coordinators and was made available through pain medicine societies. Results: Seventy-one of four hundred and twenty-three pain medicine fellows (17% response rate) completed the survey. Nine percent of respondents evidence-informed opinion coincided with the most recent Polyanalgesic Consensus Conference (PACC) guidelines recommendations for IDDS treatment indications. Fifty-one percent of respondents felt there was an unmet need for IDDS training. About one-third of respondents felt that lack of curriculum, faculty, and cases were barriers to IDDS use, respectively. Thirty-one percent of fellows reported sufficient training for IDDS in their fellowship programs. The majority (70%) of respondents somewhat or strongly support direct training by IDDS manufacturers. Conclusion: A wide variability exists surrounding IDDS training during ACGME accredited pain medicine fellowship. Insufficient case exposure and lack of a standardized curriculum may play a role in future therapy adoption. The results from this study call for a more standardized training approach with an emphasis on adequate clinical exposure, utilization of peer reviewed educational curriculum and supplemental material to aid pain medicine fellows' education.
Language	English
Publishing date	2023-12-27
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2495284-9
ISSN	1178-7090
ISSN	1178-7090
DOI	10.2147/JPR.S428851
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Article: No Zero Sum in Opioids for Chronic Pain: Neurostimulation and the Goal of Opioid Sparing, Not Opioid Eradication.

Schatman, Michael E / Petersen, Erika A / Sayed, Dawood

Journal of pain research

2021 Volume 14, Page(s) 1809–1812

Language	English
Publishing date	2021-06-16
Publishing country	New Zealand
Document type	Editorial
ZDB-ID	2495284-9
ISSN	1178-7090
ISSN	1178-7090
DOI	10.2147/JPR.S323661
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Article ; Online: Improvement in Protective Sensation: Clinical Evidence From a Randomized Controlled Trial for Treatment of Painful Diabetic Neuropathy With 10 kHz Spinal Cord Stimulation.

Argoff, Charles E / Armstrong, David G / Kagan, Zachary B / Jaasma, Michael J / Bharara, Manish / Bradley, Kerry / Caraway, David L / Petersen, Erika A

Journal of diabetes science and technology

2024 , Page(s) 19322968231222271

Abstract: Background: Painful diabetic neuropathy (PDN) can result in the loss of protective sensation, in which people are at twice the likelihood of foot ulceration and three times the risk of lower extremity amputation. Here, we evaluated the long-term effects ...

Abstract	Background: Painful diabetic neuropathy (PDN) can result in the loss of protective sensation, in which people are at twice the likelihood of foot ulceration and three times the risk of lower extremity amputation. Here, we evaluated the long-term effects of high-frequency (10 kHz) paresthesia-independent spinal cord stimulation (SCS) on protective sensation in the feet and the associated risk of foot ulceration for individuals with PDN. Methods: The SENZA-PDN clinical study was a randomized, controlled trial in which 216 participants with PDN were randomized to receive either conventional medical management (CMM) alone or 10 kHz SCS plus CMM, with optional treatment crossover after 6 months. At study visits (baseline through 24 months), 10-g monofilament sensory assessments were conducted at 10 locations per foot. Two published methods were used to evaluate protective sensation via classifying risk of foot ulceration. Results: Participants in the 10 kHz SCS group reported increased numbers of sensate locations as compared to CMM alone ( Conclusions: Significant improvements were observed in protective sensation from preimplantation to 24 months postimplantation for the 10 kHz SCS group. With this unique, disease-modifying improvement in sensory function, 10 kHz SCS provides the potential to reduce ulceration, amputation, and other severe sequelae of PDN. Trial registration: The SENZA-PDN study is registered on ClinicalTrials.gov with identifier NCT03228420.
Language	English
Publishing date	2024-01-09
Publishing country	United States
Document type	Journal Article
ISSN	1932-2968
ISSN (online)	1932-2968
DOI	10.1177/19322968231222271
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Article ; Online: First evidence of a biomarker-based dose-response relationship in chronic pain using physiological closed-loop spinal cord stimulation.

Muller, Leah / Pope, Jason / Verrills, Paul / Petersen, Erika / Kallewaard, Jan Willem / Gould, Ian / Karantonis, Dean M

Regional anesthesia and pain medicine

2024

Abstract: Background and objectives: In spinal cord stimulation (SCS) therapy, electricity is the medication delivered to the spinal cord for pain relief. In contrast to conventional medication where dose is determined by desired therapeutic plasma concentration, ...

Abstract	Background and objectives: In spinal cord stimulation (SCS) therapy, electricity is the medication delivered to the spinal cord for pain relief. In contrast to conventional medication where dose is determined by desired therapeutic plasma concentration, there is lack of equivalent means of determining dose delivery in SCS. In open-loop (OL) SCS, due to the dynamic nature of the epidural space, the activating electric field delivered is inconsistent at the level of the dorsal columns. Recent Food and Drug Administration guidance suggests accurate and consistent therapy delivered using physiologic closed-loop control (PCLC) devices can minimize underdosage or overdosage and enhance medical care. PCLC-based evoked compound action potential (ECAP)-controlled technology provides the ability to prescribe a precise stimulation dose unique to each patient, continuously measure neural activation, and objectively inform SCS therapy optimization. Methods: Neurophysiological indicator metrics of therapy dose, usage above neural activation threshold, and accuracy of SCS therapy were assessed for relationship with pain reduction in over 600 SCS patients. Results: Significant relationships between objective metrics and pain relief across the patient population are shown, including first evidence for a dose-response relationship in SCS. Conclusions: Higher dose, more time over ECAP threshold, and higher accuracy are associated with better outcomes across patients. There is potential to optimize individual patient outcomes based on unique objective measurable electrophysiological inputs.
Language	English
Publishing date	2024-03-19
Publishing country	England
Document type	Journal Article
ZDB-ID	1425299-5
ISSN	1532-8651 ; 1098-7339 ; 0146-521X
ISSN (online)	1532-8651
ISSN	1098-7339 ; 0146-521X
DOI	10.1136/rapm-2024-105346
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