title: Effect of Interactive Neurostimulation Therapy on Inflammatory Response in Patients With Chronic and Recurrent Mechanical Neck Pain.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the effect of treatment with a novel noninvasive interactive neurostimulation device (InterX5000) on the production of inflammatory biomarkers in chronic and recurrent mechanical neck pain (NP) syndrome.
  
  
  METHODS
  This study represents pilot biological data from a randomized controlled clinical trial. Twenty-five NP patients and 14 asymptomatic subjects included for baseline comparison only completed the study. The patients received 6 InterX5000 or placebo treatments within 2 weeks, and pretreatment and post-treatment blood samples were collected for in vitro determination of biomarker production. Whole blood cell cultures were activated by lipopolysaccharide or by the combination of lipopolysaccharide and phytohemagglutinin for 24 to 48 hours. The levels of tumor necrosis factor α (TNFα) and its soluble type II receptor (sTNFR II), interleukin (IL) 1, IL-1 receptor antagonist (IL-1RA), IL-6, IL-10, and monocyte chemotactic protein (CCL2/MCP-1) were determined by specific immunoassays.
  
  
  RESULTS
  Compared with asymptomatic subjects, baseline production levels of all proinflammatory mediators (TNFα, IL-1β, IL-6, and CCL2/MCP-1) were significantly augmented or trended higher (P = .000-.008) in patients with NP. Of the anti-inflammatory markers, only IL-1RA was significantly elevated (P = .004). The increase in IL-10 and tumor necrosis factor receptor II levels did not reach statistical significance. Neither InterX5000 nor placebo therapy had any significant effect on the production of the inflammatory mediators over the study period.
  
  
  CONCLUSIONS
  This investigation determined that inflammatory cytokine pathways are activated in NP patients but found no evidence that a short course of InterX5000 treatment normalized the production of inflammatory biomarkers.
authors.affiliation: Associate Professor, Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors.forename: Julita A
authors.initials: JA
authors.lastname: Teodorczyk-Injeyan
authors.affiliation: Professor, Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors.forename: John J
authors.initials: JJ
authors.lastname: Triano
authors.affiliation: Acting Dean, Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
authors.forename: Marion
authors.initials: M
authors.lastname: McGregor
authors.affiliation: Associate Professor, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada; Scientific Director, Alberta Health Services' Bone and Joint Health Strategic Clinical Network, Edmonton, AB, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Woodhouse
authors.affiliation: Professor and Chair, Department of Pathology and Microbiology, Canadian Memorial Chiropractic College, Toronto, ON, Canada. Electronic address: sinjeyan@cmcc.ca.
authors.forename: H Stephen
authors.initials: HS
authors.lastname: Injeyan
mesh_terms: D000328:Adult; D015415:Biomarkers; D059350:Chronic Pain / Q000150:complications / Q000276:immunology* / Q000628:therapy*; D016207:Cytokines / Q000096:biosynthesis; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology; D008297:Male; D019547:Neck Pain / Q000150:complications / Q000276:immunology* / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D012008:Recurrence
chemical_list: D015415:Biomarkers; D016207:Cytokines
keywords: Cytokines; Electrotherapy; Inflammation; Neck Pain