Psychological Screening/Phenotyping as Predictors for Spinal Cord Stimulation

Curr Pain Headache Rep, 2013 · DOI: 10.1007/s11916-012-0307-6 · Published: January 1, 2013

Simple Explanation

Spinal Cord Stimulation (SCS) is used for pain when other treatments fail. Patient selection is key because SCS benefits vary and it has risks. Psychological factors greatly influence pain and treatment response. Assessing these factors, along with sensory testing, helps determine who will benefit most from SCS. Psychological evaluations assess emotional reactions, thinking patterns, behavior, and social issues that affect pain and disability, to tailor treatment effectively.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review article

Key Findings

1
Psychological factors like somatization, depression, and anxiety are strong predictors of poor response to spinal cord stimulation.
2
Depression is significantly linked to reduced efficacy of SCS, but can improve with successful SCS treatment.
3
QST studies suggest pretreatment pain sensitivity predicts worse post-treatment outcomes.

Research Summary

Psychological screening and QST can help predict SCS outcomes. Psychological factors such as depression and anxiety are key predictors of success. QST measures, including pain thresholds and temporal summation, may offer objective markers for guiding patient selection. Functional neuroimaging studies show SCS affects brain activity in pain-relevant regions, suggesting potential mechanisms for pain reduction.

Practical Implications

Improved Patient Selection

Objective assessments can aid in selecting appropriate SCS candidates, sparing unsuitable patients from invasive procedures.

Tailored Treatment Plans

Identifying modifiable risk factors and addressing psychological issues may enhance SCS outcomes.

Future Research Directions

Further studies are needed to determine specific assessment components and cut-off levels for psychological measures and QST in SCS patient selection.

Study Limitations

1
Lack of consensus on specific psychological assessment components and cut-off levels.
2
Limited long-term follow-up studies evaluating the impact of psychological factors and QST on SCS outcomes.
3
The mechanisms of action for successful SCS remain poorly understood.

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