Cerebrospinal fluid levels of vascular endothelial growth factor correlate with reported pain and are reduced by spinal cord stimulation in patients with failed back surgery syndrome.
Neuromodulation
; 16(6): 519-22; discussion 522, 2013.
Article
em En
| MEDLINE
| ID: mdl-23136965
ABSTRACT
OBJECTIVES:
Spinal cord stimulation (SCS) is an efficacious therapy for chronic neuropathic pain whose precise mechanism of action is unclear. Mediators produced by glial and immune cells are now believed to modulate neuronal transmission and promote chronic neuropathic pain. We postulated a relationship between cerebrospinal fluid (CSF) concentrations of neuroimmune mediators and SCS. MATERIALS ANDMETHODS:
We measured CSF concentrations of the chemokine, monocyte chemotactic protein-1 (MCP-1), and the growth factors, brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor (VEGF) and tested for relationships with stimulation parameters and clinical response in nine patients with failed back surgery syndrome (FBSS).RESULTS:
Patients with FBSS had higher CSF concentrations of BDNF (p = 0.01) and MCP-1 (p = 0.0001) than matched controls. CSF concentrations of BDNF and VEGF correlated with reported pain (p = 0.04). Five minutes of SCS resulted in a reduction in median VEGF concentrations (p = 0.01).CONCLUSIONS:
Patients with FBSS have altered CSF levels of BDNF and MCP-1. CSF VEGF correlates with pain and is reduced by SCS. This may offer novel insights into both the mechanism of action of SCS in FBSS and the variation in clinical response that may be encountered.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Cirurgia_oncologica
Base de dados:
MEDLINE
Assunto principal:
Fator A de Crescimento do Endotélio Vascular
/
Síndrome Pós-Laminectomia
/
Estimulação da Medula Espinal
/
Neuralgia
Tipo de estudo:
Etiology_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Neuromodulation
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Irlanda