OBJECTIVE Despite the clinical effectiveness of Spinal Cord Stimulation (SCS), potential structural brain modifications have not been explored. Our aim was to identify structural volumetric changes during subsensory SCS, in patients with Failed Back Surgery Syndrome (FBSS). METHODS In this cohort study, twenty-two FBSS patients underwent a magnetic resonance imaging protocol before SCS and 3 months after SCS. Clinical parameters were correlated with volumetric changes, calculated with voxel-based morphometry. RESULTS After 3 months, a significant volume decrease was found in the inferior frontal gyrus, precuneus, cerebellar posterior lobe and middle temporal gyrus. Significant increases were found in the inferior temporal gyrus, precentral gyrus and the middle frontal gyrus after SCS. Additionally, significant increases in volume of superior frontal and parietal white matter and a significant decrease in volume of white matter underlying the premotor/middle frontal gyrus were revealed after SCS. A significant correlation was highlighted between white matter volume underlying premotor/middle frontal gyrus and leg pain relief. CONCLUSIONS This study revealed for the first time that SCS is able to induce volumetric changes in gray and white matter, suggesting the reversibility of brain alterations after chronic pain treatment. SIGNIFICANCE Volumetric brain alterations are observable after 3 months of subsensory SCS in FBSS patients.

中文翻译：

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脊髓刺激对腰椎手术失败综合征患者基于体素的脑形态测量的影响

目的 尽管脊髓刺激 (SCS) 具有临床有效性，但尚未探索潜在的大脑结构改变。我们的目标是确定背部手术失败综合征 (FBSS) 患者在亚感觉 SCS 期间的结构体积变化。方法 在这项队列研究中，22 名 FBSS 患者在 SCS 前和 SCS 后 3 个月接受了磁共振成像方案。临床参数与体积变化相关，使用基于体素的形态测量法计算。结果 3个月后，额下回、楔前叶、小脑后叶和颞中回的体积显着减少。SCS后颞下回、中央前回和额中回显着增加。此外，SCS 后显示，上额叶和顶叶白质的体积显着增加，运动前/额中回下方的白质体积显着减少。运动前/额中回的白质体积与腿部疼痛缓解之间的显着相关性得到强调。结论 本研究首次揭示 SCS 能够诱导灰质和白质的体积变化，表明慢性疼痛治疗后大脑改变的可逆性。意义 在 FBSS 患者进行 3 个月的亚感觉 SCS 后，可以观察到体积大脑的改变。运动前/额中回的白质体积与腿部疼痛缓解之间的显着相关性得到强调。结论 本研究首次揭示 SCS 能够诱导灰质和白质的体积变化，表明慢性疼痛治疗后大脑改变的可逆性。意义 在 FBSS 患者进行 3 个月的亚感觉 SCS 后，可以观察到体积大脑的改变。运动前/额中回的白质体积与腿部疼痛缓解之间的显着相关性得到强调。结论 本研究首次揭示 SCS 能够诱导灰质和白质的体积变化，表明慢性疼痛治疗后大脑改变的可逆性。意义 在 FBSS 患者进行 3 个月的亚感觉 SCS 后，可以观察到体积大脑的改变。