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Influence of Spinal Cord Stimulation on Insulin Sensitivity in Chronic Pain Patients
Experimental and Clinical Endocrinology & Diabetes ( IF 1.8 ) Pub Date : 2021-07-12 , DOI: 10.1055/a-1525-3339
Matthias H Morgalla 1 , Hannah Fritschle 1 , Andreas Vosseler 2, 3, 4 , Charlotte Benkendorff 2 , Apostolia Lamprinou 2, 3, 4 , Martin Heni 2, 3, 4 , Andreas Fritsche 2, 3, 4
Affiliation  

Background and Objective This prospective, sham-controlled, randomized, cross-over study (NCT03637075), was designed to test the hypothesis that spinal cord stimulation (SCS) for the treatment of pain can also improve glucose metabolism and insulin sensitivity when compared to sham stimulation. Methods Ten non-diabetic participants (5 females, mean age 48.8 years) who had an SCS system implanted for the treatment of chronic neuropathic pain were studied. Whilst applying a hyperinsulinemic-euglycemic clamp, sham-stimulation and tonic stimulation were performed for 45 min (n=4) or 60 min (n=6) in each case randomly. The insulin sensitivity index and pain levels were determined. A second investigation, BurstDR stimulation was also conducted and the result was compared to that of sham stimulation (cross-over design). Results The insulin sensitivity improved significantly under the tonic stimulation when compared to the sham stimulation (p=0.037). BurstDR stimulation independently did not lead to a significantly improved insulin sensitivity compared to that after sham stimulation (p=0.16). We also examined the pain during the test and found no significant difference between sham and tonic stimulation (p=0.687). Conclusion The results of this study show that tonic stimulation used for the treatment of pain could also improve glucose metabolism and insulin sensitivity. Further investigations are required to investigate the clinical relevance of the role of glucose metabolism in diabetic chronic pain participants and its underlying mechanisms.

中文翻译:

脊髓刺激对慢性疼痛患者胰岛素敏感性的影响

背景和目的 这项前瞻性、假手术对照、随机、交叉研究 (NCT03637075) 旨在检验与假手术相比,用于治疗疼痛的脊髓刺激 (SCS) 还可以改善葡萄糖代谢和胰岛素敏感性的假设刺激。方法 对 10 名非糖尿病患者(5 名女性,平均年龄 48.8 岁)进行了研究,他们植入了用于治疗慢性神经性疼痛的 SCS 系统。在应用高胰岛素-正常血糖钳夹的同时,在每种情况下随机进行假刺激和强直刺激 45 分钟(n=4)或 60 分钟(n=6)。测定胰岛素敏感性指数和疼痛水平。第二项调查,BurstDR 刺激也进行了,结果与假刺激(交叉设计)的结果进行了比较。结果与假刺激相比,强直刺激下的胰岛素敏感性显着提高(p=0.037)。与假刺激后相比,BurstDR 刺激独立并没有导致胰岛素敏感性显着提高(p = 0.16)。我们还检查了测试期间的疼痛,发现假刺激和强直刺激之间没有显着差异(p=0.687)。结论 本研究结果表明,用于治疗疼痛的强直刺激还可以改善葡萄糖代谢和胰岛素敏感性。需要进一步的研究来研究葡萄糖代谢在糖尿病慢性疼痛参与者中的作用及其潜在机制的临床相关性。与假刺激后相比,BurstDR 刺激独立并没有导致胰岛素敏感性显着提高(p = 0.16)。我们还检查了测试期间的疼痛,发现假刺激和强直刺激之间没有显着差异(p=0.687)。结论 本研究结果表明,用于治疗疼痛的强直刺激还可以改善葡萄糖代谢和胰岛素敏感性。需要进一步的研究来研究葡萄糖代谢在糖尿病慢性疼痛参与者中的作用及其潜在机制的临床相关性。与假刺激后相比,BurstDR 刺激独立并没有导致胰岛素敏感性显着提高(p = 0.16)。我们还检查了测试期间的疼痛,发现假刺激和强直刺激之间没有显着差异(p=0.687)。结论 本研究结果表明,用于治疗疼痛的强直刺激还可以改善葡萄糖代谢和胰岛素敏感性。需要进一步的研究来研究葡萄糖代谢在糖尿病慢性疼痛参与者中的作用及其潜在机制的临床相关性。结论 本研究结果表明,用于治疗疼痛的强直刺激还可以改善葡萄糖代谢和胰岛素敏感性。需要进一步的研究来研究葡萄糖代谢在糖尿病慢性疼痛参与者中的作用及其潜在机制的临床相关性。结论 本研究结果表明,用于治疗疼痛的强直刺激还可以改善葡萄糖代谢和胰岛素敏感性。需要进一步的研究来研究葡萄糖代谢在糖尿病慢性疼痛参与者中的作用及其潜在机制的临床相关性。
更新日期:2021-07-13
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