Spinal cord stimulation to treat chronic pain

Presented by Adrian Porras Laura, Graduate Student at the University of Michigan

Spinal cord stimulation (SCS) is an electrical stimulation therapy that is used to treat chronic pain. Electrical stimulation therapies, such as SCS, represent nonpharmacologic treatment options for pain management and a multi-billion dollar per year medical device market. Although these technologies have existed for decades and are currently used to treat thousands of patients a year, some patients respond remarkably well to these therapies, while other patients fail to achieve sufficient pain relief. The reasons behind these mixed outcomes are unknown and likely attributed to our poor scientific understanding of how SCS works. Therefore, here we utilize a hybrid computational modeling approach to systematically characterize both preclinical and clinical applications of SCS. For preclinical SCS studies, we use this approach to account for gross anatomical differences across species to properly scale stimulation parameters between preclinical and clinical conditions. For clinical SCS studies, we design patient-specific models that are validated with clinical data to account for several sources of variability across patients. In this seminar talk, I will present results that provide valuable insight into outcome variability across patients and clinically appropriate stimulus dosage for preclinical models. We believe this systematic approach will improve our understanding of the mechanisms of action of SCS and other neurostimulation therapies and help explain why they work in some patients but not others. We also expect that the knowledge gained from this type of approach will help improve patient selection and several aspects of these neurostimulation technologies (e.g., stimulation parameters, lead design).