BMJ Open (Nov 2024)

Differential target multiplexed spinal cord stimulation in patients with Persistent Spinal Pain Syndrome Type II: a study protocol for a 12-month multicentre cohort study (DETECT)

  • Philippe De Vloo,
  • Maxime Billot,
  • Sam Eldabe,
  • Anaïs Van Hoylandt,
  • Manuel Roulaud,
  • Philippe Rigoard,
  • Mark Plazier,
  • Lisa Goudman,
  • Maarten Moens,
  • Tom Theys,
  • Ann De Smedt,
  • Bart Billet,
  • Dimitri Vanhauwaert,
  • Pieter-Jan Germonpré,
  • Jeroen Ceuppens,
  • Christ Declerck,
  • Hannie Braems,
  • Johan Vangeneugden,
  • Bart Bryon,
  • Thibault Remacle,
  • Raf Van Paesschen,
  • Sofie Denkens,
  • Laura Verschueren,
  • Vincent Raymaekers,
  • Jean-Pierre Van Buyten,
  • Iris Smet,
  • Ali Jerjir,
  • Michel Turlot,
  • Stefaan Goossens,
  • Patricia Da Silva,
  • Ella Ver Donck,
  • Mayken Gorissen

DOI
https://doi.org/10.1136/bmjopen-2023-083610
Journal volume & issue
Vol. 14, no. 11

Abstract

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Introduction Differential target multiplexed spinal cord stimulation (DTM SCS) is a new stimulation paradigm for chronic pain management with the aim of modulating glial cells and neurons in order to rebalance their interactions. Animal studies revealed positive effects of this type of stimulation; however, studies in humans are still scarce, pointing towards the need for an evaluation of the effectiveness and safety of DTM SCS in clinical settings. Furthermore, the differential target multiplexed (DTM) algorithm consists of a combination of several programmes, which will presumably consume more energy from the spinal cord stimulation (SCS) battery. Therefore, the objective of DETECT is to investigate the feasibility, effectiveness and safety of DTM SCS in patients with Persistent Spinal Pain Syndrome Type II through a longitudinal cohort study.Methods and analysis DETECT is a prospective multicentre cohort study (n≥250) with a follow-up until 12 months after receiving DTM SCS. The study initiated in October 2021 and is currently still recruiting patients. Self-reporting outcome variables were evaluated at baseline (before SCS) and at 1, 6 and 12 months of DTM SCS. The primary effectiveness endpoint is overall pain intensity, measured with the visual analogue scale. Secondary effectiveness outcome measures are back pain intensity, leg pain intensity, disability, health-related quality of life, pain medication use, functional disability, clinical holistic responder status, self-management, impression of change, work status, pain catastrophising, symptoms of central sensitisation, anxiety, depression and healthcare utilisation. Time spent in different body postures and SCS stimulation parameters will be read out from the pulse generator. The prevalence of technical issues, recharge frequency, (serious) adverse events and the proportion of successful DTM trials will be collected as well. Longitudinal mixed models will be calculated to evaluate the effectiveness of DTM SCS over time.Ethics and dissemination The study protocol was approved by the central Ethics Committee of the Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (B.U.N.1432021000563) and the Ethics Committees of each participating centre. Research findings will be disseminated to key stakeholders through peer-reviewed publications in scientific journals and presentations to clinical audiences.Trial registration number NCT05068011.