Open AccessA Call to Action Toward Optimizing the Electrical Dose Received by Neural Targets in Spinal Cord Stimulation Therapy for Neuropathic Pain
Author(s) -
Krishnan Chakravarthy,
Rajiv Reddy,
Adnan AlKaisy,
Thomas Yearwood,
Jay S. Grider
Publication year - 2021
Publication title -
journal of pain research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 49
ISSN - 1178-7090
DOI - 10.2147/jpr.s323372
Subject(s) - medicine , dosing , neuromodulation , neuropathic pain , stimulation , spinal cord , spinal cord stimulation , chronic pain , spinal cord stimulator , neuroscience , anesthesia , pharmacology , physical therapy , psychiatry , biology
Spinal cord stimulation has seen unprecedented growth in new technology in the 50 years since the first subdural implant. As we continue to grow our understanding of spinal cord stimulation and relevant mechanisms of action, novel questions arise as to electrical dosing optimization. Programming adjustment - dose titration - is often a process of trial and error that can be time-consuming and frustrating for both patient and clinician. In this report, we review the current preclinical and clinical knowledge base in order to provide insights that may be helpful in developing more rational approaches to spinal cord stimulation dosing. We also provide key conclusions that may help in directing future research into electrical dosing, given the advent of newer waveforms outside traditional programming parameters.