Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial.

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  • Additional Information
    • Author-Supplied Keywords:
      Chronic pain
      double‐blind
      high frequency
      high frequency SCS
      kilohertz SCS
      PROCO
      randomized controlled trial
      sub‐perception SCS
    • Abstract:
      Objective: The PROCO RCT is a multicenter, double‐blind, crossover, randomized controlled trial (RCT) that investigated the effects of rate on analgesia in kilohertz frequency (1–10 kHz) spinal cord stimulation (SCS). Materials and Methods: Patients were implanted with SCS systems and underwent an eight‐week search to identify the best location (“sweet spot”) of stimulation at 10 kHz within the searched region (T8–T11). An electronic diary (e‐diary) prompted patients for pain scores three times per day. Patients who responded to 10 kHz per e‐diary numeric rating scale (ED‐NRS) pain scores proceeded to double‐blind rate randomization. Patients received 1, 4, 7, and 10 kHz SCS at the same sweet spot found for 10 kHz in randomized order (four weeks at each frequency). For each frequency, pulse width and amplitude were titrated to optimize therapy. Results: All frequencies provided equivalent pain relief as measured by ED‐NRS (p ≤ 0.002). However, mean charge per second differed across frequencies, with 1 kHz SCS requiring 60–70% less charge than higher frequencies (p ≤ 0.0002). Conclusions: The PROCO RCT provides Level I evidence for equivalent pain relief from 1 to 10 kHz with appropriate titration of pulse width and amplitude. 1 kHz required significantly less charge than higher frequencies. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Department of Anesthesiology, Basildon and Thurrock University Hospitals NHS Foundation Trust, Basildon, Essex, UK
      2Department of Anesthesiology, University College London Hospitals NHS Foundation Trust, Bloomsbury, London, UK
      3Department of Anesthesiology, Trust Headquarters Southmead Hospital, North Bristol NHS Trust, Bristol, UK
      4Neurosurgery, Trust Headquarters Southmead Hospital, North Bristol NHS Trust, Bristol, UK
      5Research and Development, Boston Scientific Neuromodulation, Valencia, CA, USA
      6Clinical, Boston Scientific Neuromodulation, Valencia, CA, USA
    • Full Text Word Count:
      8463
    • ISSN:
      1094-7159
    • Accession Number:
      10.1111/ner.12746
    • Accession Number:
      127287394
  • Citations
    • ABNT:
      THOMSON, S. J. et al. Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial. Neuromodulation, [s. l.], v. 21, n. 1, p. 67–76, 2018. DOI 10.1111/ner.12746. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=127287394&custid=s6224580. Acesso em: 19 fev. 2020.
    • AMA:
      Thomson SJ, Tavakkolizadeh M, Love JS, et al. Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial. Neuromodulation. 2018;21(1):67-76. doi:10.1111/ner.12746.
    • APA:
      Thomson, S. J., Tavakkolizadeh, M., Love, J. S., Patel, N. K., Gu, J. W., Bains, A., Doan, Q., & Moffitt, M. (2018). Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial. Neuromodulation, 21(1), 67–76. https://doi.org/10.1111/ner.12746
    • Chicago/Turabian: Author-Date:
      Thomson, Simon J., Moein Tavakkolizadeh, Jones, Sarah Love, Nikunj K. Patel, Jianwen Wendy Gu, Amarpreet Bains, Que Doan, and Michael Moffitt. 2018. “Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial.” Neuromodulation 21 (1): 67–76. doi:10.1111/ner.12746.
    • Harvard:
      Thomson, S. J. et al. (2018) ‘Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial’, Neuromodulation, 21(1), pp. 67–76. doi: 10.1111/ner.12746.
    • Harvard: Australian:
      Thomson, SJ, Tavakkolizadeh, M, Love, JS, Patel, NK, Gu, JW, Bains, A, Doan, Q & Moffitt, M 2018, ‘Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial’, Neuromodulation, vol. 21, no. 1, pp. 67–76, viewed 19 February 2020, .
    • MLA:
      Thomson, Simon J., et al. “Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial.” Neuromodulation, vol. 21, no. 1, Jan. 2018, pp. 67–76. EBSCOhost, doi:10.1111/ner.12746.
    • Chicago/Turabian: Humanities:
      Thomson, Simon J., Moein Tavakkolizadeh, Jones, Sarah Love, Nikunj K. Patel, Jianwen Wendy Gu, Amarpreet Bains, Que Doan, and Michael Moffitt. “Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial.” Neuromodulation 21, no. 1 (January 2018): 67–76. doi:10.1111/ner.12746.
    • Vancouver/ICMJE:
      Thomson SJ, Tavakkolizadeh M, Love JS, Patel NK, Gu JW, Bains A, et al. Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial. Neuromodulation [Internet]. 2018 Jan [cited 2020 Feb 19];21(1):67–76. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=a9h&AN=127287394&custid=s6224580