Clinical study of short-term spinal cord stimulation for herpes zoster-associated pain

Abstract Background Zoster-associated neuralgia refers to neuropathic pain from herpes zoster, which can persist as postherpetic neuralgia (PHN). Preventing the progression to chronic PHN is crucial, yet optimal interventions is still not clear. Objectives This study evaluates the efficacy of short-...

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Main Authors: Lei Zuo, Ai Su, YaChen Xie, XiaoQiu Yang
Format: Article
Language:English
Published: BMC 2024-12-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-024-02196-6
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author Lei Zuo
Ai Su
YaChen Xie
XiaoQiu Yang
author_facet Lei Zuo
Ai Su
YaChen Xie
XiaoQiu Yang
author_sort Lei Zuo
collection DOAJ
description Abstract Background Zoster-associated neuralgia refers to neuropathic pain from herpes zoster, which can persist as postherpetic neuralgia (PHN). Preventing the progression to chronic PHN is crucial, yet optimal interventions is still not clear. Objectives This study evaluates the efficacy of short-term spinal cord stimulation (tSCS) in patients with subacute and chronic PHN. Methods A clinical study involved 135 patients with herpes zoster-associated pain (HZAP), divided into two groups: Experimental group which received short-term spinal cord stimulation therapy, and Control group which received conventional medical treatment and nerve block therapy. Pain intensity, sleep quality, anxiety and depression and quality of life were assessed at baseline and at 2 weeks, 1-, 3-, 6-, and 12-month post-treatment. Univariate and multivariate analyses identified factors associated with treatment efficacy. Results At 1-month follow-up, the experimental group showed significantly higher efficacy in pain reduction (P < 0.01). Higher Pittsburgh Sleep Quality Index (β = 0.093, P = 0.004) and PHQ-9 scores (β = 0.065, P = 0.031) before treatment were associated with better outcomes. At 3 months, longer disease duration (β = 0.103, P = 0.008) and higher Pittsburgh Sleep Quality Index scores (β = 0.114, P = 0.002) correlated with better efficacy, while higher Patient Health Questionnaire-9 scores were negatively correlated (β = − 0.023, P = 0.036). Although as follow-up time increases, the significant superiority of efficacy gradually shrinks compared with nerve block therapy at 6–12 months, the tSCS group still had better effects in improving sleep quality, anxiety and depression symptoms, and quality of life. Conclusions Short-term spinal cord stimulation is a safe and effective short-term treatment for HZAP, offering faster and more effective pain relief and quality of life improvement compared to nerve block therapy. However, there are challenges in maintaining the long-term effects of tSCS. Further studies with larger samples are needed to confirm these findings.
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spelling doaj-art-eefb2e932ae94e44979bfc176b84aac72024-12-22T12:22:41ZengBMCEuropean Journal of Medical Research2047-783X2024-12-0129111210.1186/s40001-024-02196-6Clinical study of short-term spinal cord stimulation for herpes zoster-associated painLei Zuo0Ai Su1YaChen Xie2XiaoQiu Yang3Department of Painology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Painology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Painology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Painology, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background Zoster-associated neuralgia refers to neuropathic pain from herpes zoster, which can persist as postherpetic neuralgia (PHN). Preventing the progression to chronic PHN is crucial, yet optimal interventions is still not clear. Objectives This study evaluates the efficacy of short-term spinal cord stimulation (tSCS) in patients with subacute and chronic PHN. Methods A clinical study involved 135 patients with herpes zoster-associated pain (HZAP), divided into two groups: Experimental group which received short-term spinal cord stimulation therapy, and Control group which received conventional medical treatment and nerve block therapy. Pain intensity, sleep quality, anxiety and depression and quality of life were assessed at baseline and at 2 weeks, 1-, 3-, 6-, and 12-month post-treatment. Univariate and multivariate analyses identified factors associated with treatment efficacy. Results At 1-month follow-up, the experimental group showed significantly higher efficacy in pain reduction (P < 0.01). Higher Pittsburgh Sleep Quality Index (β = 0.093, P = 0.004) and PHQ-9 scores (β = 0.065, P = 0.031) before treatment were associated with better outcomes. At 3 months, longer disease duration (β = 0.103, P = 0.008) and higher Pittsburgh Sleep Quality Index scores (β = 0.114, P = 0.002) correlated with better efficacy, while higher Patient Health Questionnaire-9 scores were negatively correlated (β = − 0.023, P = 0.036). Although as follow-up time increases, the significant superiority of efficacy gradually shrinks compared with nerve block therapy at 6–12 months, the tSCS group still had better effects in improving sleep quality, anxiety and depression symptoms, and quality of life. Conclusions Short-term spinal cord stimulation is a safe and effective short-term treatment for HZAP, offering faster and more effective pain relief and quality of life improvement compared to nerve block therapy. However, there are challenges in maintaining the long-term effects of tSCS. Further studies with larger samples are needed to confirm these findings.https://doi.org/10.1186/s40001-024-02196-6Herpes zosterShort-term spinal cord stimulationNeuromodulation
spellingShingle Lei Zuo
Ai Su
YaChen Xie
XiaoQiu Yang
Clinical study of short-term spinal cord stimulation for herpes zoster-associated pain
European Journal of Medical Research
Herpes zoster
Short-term spinal cord stimulation
Neuromodulation
title Clinical study of short-term spinal cord stimulation for herpes zoster-associated pain
title_full Clinical study of short-term spinal cord stimulation for herpes zoster-associated pain
title_fullStr Clinical study of short-term spinal cord stimulation for herpes zoster-associated pain
title_full_unstemmed Clinical study of short-term spinal cord stimulation for herpes zoster-associated pain
title_short Clinical study of short-term spinal cord stimulation for herpes zoster-associated pain
title_sort clinical study of short term spinal cord stimulation for herpes zoster associated pain
topic Herpes zoster
Short-term spinal cord stimulation
Neuromodulation
url https://doi.org/10.1186/s40001-024-02196-6
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