title: The Effect of High-Frequency Stimulation on Sensory Thresholds in Chronic Pain Patients.
abstract: BACKGROUND
  High-frequency stimulation (HFS) has recently gained attention as an alternative to parameters used in traditional spinal cord stimulation (SCS). Because HFS is paresthesia free, the gate theory of pain control as a basis of SCS has been called into question. The mechanism of action of HFS remains unclear.
  
  
  OBJECTIVE
  We compare the effects of HFS and traditional SCS on quantitative sensory testing parameters to provide insight into how HFS modulates the nervous system.
  
  
  METHODS
  Using quantitative sensory testing, we measured thermal detection and pain thresholds and mechanical detection and pressure pain thresholds, as well as vibratory detection, in 20 SCS patients off stimulation (OFF), on traditional stimulation (ON) and on HFS in a randomized order.
  
  
  RESULTS
  HFS significantly increased the mechanical detection threshold compared to OFF stimulation (p < 0.001) and traditional SCS (p = 0.01). Pressure pain detection and vibratory detection thresholds also significantly increased with HFS compared to ON states (p = 0.04 and p = 0.01, respectively). In addition, HFS significantly decreased 10- and 40-gram pinprick detection compared to OFF states (both p = 0.01). No significant differences between OFF, ON and HFS states were seen in thermal and thermal pain detection.
  
  
  CONCLUSIONS
  HFS is a new means of modulating chronic pain. The mechanism by which HFS works seems to differ from that of traditional SCS, offering a new platform for innovative advancements in treatment and a greater potential to treat patients by customizing waveforms.
authors.affiliation: Department of Neurosurgery, Albany Medical Center, Albany, N.Y., USA.
authors.forename: Youngwon
authors.initials: Y
authors.lastname: Youn
authors.forename: Heather
authors.initials: H
authors.lastname: Smith
authors.forename: Brian
authors.initials: B
authors.lastname: Morris
authors.forename: Charles
authors.initials: C
authors.lastname: Argoff
authors.forename: Julie G
authors.initials: JG
authors.lastname: Pilitsis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold / Q000502:physiology*; D012684:Sensory Thresholds / Q000502:physiology; D062187:Spinal Cord Stimulation / Q000379:methods*; D013696:Temperature; D055698:Touch Perception / Q000502:physiology*; D014732:Vibration