Can the outcome of spinal cord stimulation in chronic complex regional pain syndrome type I patients be predicted by catastrophizing thoughts?
BACKGROUND
In this study, we examined whether pain catastrophizing is a predictor of spinal cord stimulation (SCS) outcome in patients with complex regional pain syndrome type I (CRPS-I).


METHODS
Participants in this prospective cohort study were 32 patients with chronic CRPS-I, who received permanent SCS after a positive response to test stimulation. Baseline assessment was performed before test stimulation and included questions on demographic variables, disease information, pain intensity, pain catastrophizing, and health-related quality of life (QOL). Follow-up assessment was performed 9 mo after final implantation and included pain intensity, global perceived effect (GPE), and QOL. Successful SCS outcome was defined as a reduction of pain intensity of at least 50% on a visual analog scale or "much improved" or "total pain relief" on GPE.


RESULTS
After 9 months, 38% of the patients had a successful outcome in reduced pain intensity and 53% of the patients in GPE. In addition, improvements were apparent on several of the domains of QOL. However, no evidence was found for the predictive value of pain catastrophizing on the efficacy of SCS in reduction of pain intensity, GPE, or QOL.


CONCLUSIONS
This study showed that the efficacy of SCS in reduction of pain intensity, GPE, and QOL in a well-defined chronic CRPS-I population was not predicted by pain catastrophizing. Therefore, we conclude that a high level of pain catastrophizing in patients with CRPS-I is not a contraindication for SCS treatment.
Lamé
Inge E
IE
Department of Pain Management, ResearchCentre, University Hospital Maastricht, The Netherlands. ingelame@telfort.n
Peters
Madelon L
ML
Patijn
Jacob
J
Kessels
Alfons G
AG
Geurts
José
J
van Kleef
Maarten
M
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life; D012019:Reflex Sympathetic Dystrophy / Q000523:psychology* / Q000628:therapy*; D012044:Regression Analysis; D013116:Spinal Cord / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult