Benefit of Tonic Versus Burst Spinal Cord Stimulation for Chemo-Induced Peripheral Neuropathy Using Psychophysical Testing

Chemotherapy-induced peripheral neuropathy (CIPN) presents a significant challenge in various chemotherapy treatments. CIPN manifests with symptoms such as numbness, tingling sensations, persistent shooting or burning pain, loss of sensation, muscle weakness, and impaired balance in the extremities. Its incidence is reported to be as high as 68% within the first month of chemotherapy and remains at 60% after three months. Current management strategies lack a universally accepted gold standard, with approaches like physical therapy, anticonvulsants, and other non-pharmacological therapies showing limited efficacy. Consequently, there is an urgent need for an effective non-pharmacological treatment option for CIPN, which would significantly benefit patients undergoing cancer treatment. There have been limited investigations into the potential of spinal cord stimulation (SCS) to enhance neuropathy and neurological function in patients with chemotherapy-induced peripheral neuropathy (CIPN), and there is a scarcity of studies examining the effects of SCS specifically on CIPN. Therefore, this proposed study aims to evaluate the effectiveness of burst versus tonic spinal cord stimulation in addressing chemotherapy-induced peripheral neuropathy. The study will assess changes in pain scores, pain medication consumption, sensory and physical function, patient-reported outcomes, and the composition of peripheral nerves and mechanoreceptors before and after spinal cord stimulation. The research holds promise in reducing the reliance on opioids in CIPN patients, making it a crucial endeavor for affected individuals and society at large. Ultimately, this will mark the first randomized, controlled trial to investigate the efficacy of tonic versus burst SCS waveforms for managing CIPN, with a focus on improving pain, sensory function, and reducing pain medication consumption. Trial registration : ClinicalTrials.gov, NCT06121232. Registered 2 November 2024, https://clinicaltrials.gov/study/NCT06121232?term=saba%20javed&rank=4