Project Details
Description
PROJECT ABSTRACT
Diabetes is the most common cause of peripheral neuropathy, a condition that impacts over 30 million Americans.
Often, this condition occurs as painful diabetic peripheral neuropathy (PDPN), which is particularly challenging
to treat in the clinic, in part due to the lack of effective treatments and the risk of dependency for opioid analgesics.
Spinal cord stimulation (SCS) is a treatment that stimulates nerve electrical activity in the spine, and is proven
to be effective for pain conditions, including PDPN, for which SCS is now FDA approved through multiple device
manufacturers. However, the mechanisms by which SCS improves pain are not yet known, and may involve
promoting neural plasticity and small fiber nerve regeneration. We hypothesize that the electrical activity in
stimulated spinal nerves with SCS treatment improves pain due to, or in parallel to, improvements in peripheral
tissue innervation. This is based on decades of research evidence that electrical stimulation can promote nerve
plasticity and regeneration. We will compare 3 PDPN treatment groups (N=15 each) across an 18mo longitudinal
study: conventional medical management (CMM), SCS treatment, or SCS with a delayed activation of the device
at 3mo post-surgery (to control for placebo effect of the surgery or device implantation). A team comprised of
neuroscientists, neurologists, a neuromodulation surgeon, and computational/biostatistical experts will collect an
8-point dataset across this study timeline, in order to rigorously compare pain improvement scores with small
and large fiber neuropathy assessments, quality of life scores, and metabolic parameters. The innovation of this
study is further driven by the inclusion of a new functional measure of small fiber nerve electrical activity, using
the Detecting Early Neuropathy (DEN) device, which employs a microneedle array to collect data on nerve
activity up to 4mm deep from the skin surface. This is the first device capable of measuring small nerve fiber
activity as a diagnostic test for small fiber peripheral neuropathy, such as diabetic neuropathy. Taken together,
this study will provide important new data on PDPN improvements with SCS treatment and whether mechanisms
include changes to small fiber tissue innervation or nerve activity.
Status | Active |
---|---|
Effective start/end date | 09/12/23 → 07/31/24 |
Funding
- National Institute of Diabetes and Digestive and Kidney Diseases: $739,792.00
Fingerprint
Explore the research topics touched on by this project. These labels are generated based on the underlying awards/grants. Together they form a unique fingerprint.