Modulation of somatosensory profiles by spinal cord stimulation in primary Raynaud's syndrome.
OBJECTIVE
Spinal cord stimulation (SCS) is an effective antinociceptive treatment for various neuropathic pain syndromes. Apart from antinociceptive action, it may modulate overall somatosensory perception. This case report targets the question of whether SCS may alter quantitative sensory testing (QST) in a patient with primary Raynaud's syndrome.


METHODS
We report on a 44-year-old female patient with primary Raynaud's syndrome who had SCS via cervical and lumbar electrodes. QST was performed in a standardized manner assessing cold detection threshold (CDT) and warm detection threshold (WDT), cold pain threshold (CPT) and heat pain threshold (HPT), mechanical detection threshold (MDT) and mechanical pain threshold (MPT) thresholds, and vibration detection threshold (VDT) and pressure pain thresholds (PPT). We tested at the dorsum of the right/left hand of the patient with engaged and disengaged SCS. Test results were compared with a control group of 80 subjects.


RESULTS
Without SCS, the patient showed a sensory decrease in CDT, MDT, MPT, and VDT. SCS influenced the perception of cold, warm, and tactile detection thresholds, whereby CDT, WDT, and VDT were impaired and MDT was improved.


CONCLUSIONS
SCS significantly modulated the somatosensory profile in a patient with primary Raynaud's syndrome. These effects were pronounced in qualities involving Aβ, C, and A∂ nerve fibers. Further investigations may help to understand the mechanisms of action of SCS.
Department of Anesthesiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. muenster@kfa.imed.uni-erlangen.de
Tino
T
Münster
Nils
N
Tiebel
Hendrikus
H
Seyer
Christian
C
Maihöfner
D000328:Adult; D002574:Cervical Vertebrae; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D059225:Nociception; D011928:Raynaud Disease / Q000628:therapy*; D012684:Sensory Thresholds; D020886:Somatosensory Disorders / Q000628:therapy*; D013116:Spinal Cord; D013697:Thermosensing; D014110:Touch