{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T15:21:08Z","timestamp":1779290468492,"version":"3.51.4"},"reference-count":65,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T00:00:00Z","timestamp":1737331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Boston Scientific Corporation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: The aim of this study was to evaluate the effects of spinal cord stimulation (SCS) on pain, neuropathic symptoms, and other health-related metrics in patients with chronic painful peripheral neuropathy (PN) from multiple etiologies. Methods: A prospective single center observational longitudinal cohort study assessed SCS efficacy from April 2023 to May 2024, with follow-ups at 2, 4, 6, and 12 months in 19 patients suffering from the painful polyneuropathy of diverse etiologies: diabetic (DPN), idiopathic (CIAP), chemotherapy-induced (CIPN), and others. Patients were implanted with a neurostimulator (WaveWriter AlphaTM, Boston Scientific Corporation, Valencia, CA, USA) and percutaneous leads targeting the lower limbs (T10\u2013T11) and, if necessary, the upper limbs (C4\u2013C7). Stimulation programming was individualized based on patient preference and best response. Assessments were performed before and after implantation and included pain intensity (VAS and DN4), neuropathic pain symptoms (NPSI and SF-MPQ-2), autonomic symptoms (SFN-SIQ and SAS), sensory and small fiber nerve injury (UENS), functionality (GAF), sleep (CPSI), global impression of change (CGI and PGI), and quality of life (EQ-VAS and EQ-5D). Intra-epidermal nerve fiber density (IENFD) via skin biopsy was also performed at baseline (diagnostic) and after 12 months to assess potential small fiber re-growth. Statistical analyses were conducted to determine the evolution of treatment success. Results: To date, 19 patients have undergone implantation and completed follow-up. SCS produced a significant consistent and sustained improvement in pain intensity by 49% in DN4 and 76% in VAS, in neuropathic pain symptoms by 73%, in autonomic symptoms by 26\u201330%, in the sensorimotor physical exam by 8%, in functionality by 44%, in sleep by 74%, and in quality of life (69% for EQ-VAS and 134% EQ-5D). Both clinicians and patients had a meaningful global impression of change, at 1.1 and 1.3, respectively. Distal intra-epidermal nerve fiber density improved by 22% at 12 months while proximal intra-epidermal nerve fiber density decreased by 18%. Conclusions: SCS is an effective therapy for managing various types of PN.<\/jats:p>","DOI":"10.3390\/jcm14020652","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T12:32:52Z","timestamp":1737376372000},"page":"652","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effects of Spinal Cord Stimulation in Patients with Small Fiber and Associated Comorbidities from Neuropathy After Multiple Etiologies"],"prefix":"10.3390","volume":"14","author":[{"given":"\u00c1ngeles","family":"Can\u00f3s-Verdecho","sequence":"first","affiliation":[{"name":"Multidisciplinary Pain Management Unit, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"},{"name":"Anaesthesiology Department, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ara","family":"Bermejo","sequence":"additional","affiliation":[{"name":"Multidisciplinary Pain Management Unit, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"},{"name":"Neurology Department, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2531-0673","authenticated-orcid":false,"given":"Beatriz","family":"Castel","sequence":"additional","affiliation":[{"name":"Multidisciplinary Pain Management Unit, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"},{"name":"Anaesthesiology Department, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Izquierdo","sequence":"additional","affiliation":[{"name":"Multidisciplinary Pain Management Unit, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"},{"name":"Anaesthesiology Department, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Robledo","sequence":"additional","affiliation":[{"name":"Multidisciplinary Pain Management Unit, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"},{"name":"Anaesthesiology Department, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6509-1714","authenticated-orcid":false,"given":"Elisa","family":"Gallach","sequence":"additional","affiliation":[{"name":"Multidisciplinary Pain Management Unit, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"},{"name":"Psychiatry Department, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Sevilla","sequence":"additional","affiliation":[{"name":"Neurology Department, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"},{"name":"CIBER of Rare Diseases (CIBERER), Carlos III Health Institute (ISCIII), Av. Monforte de Lemos, 3-5, Pabell\u00f3n 11, Planta 0, 28029 Madrid, Spain"},{"name":"Department of Medicine, Faculty of Medicine, Universitat de Val\u00e8ncia, Av. Blasco Ib\u00e1\u00f1ez 15, 46010 Valencia, Spain"},{"name":"Neuromuscular and Ataxias Research Group, Instituto de Investigaci\u00f3n Sanitaria La Fe, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Argente","sequence":"additional","affiliation":[{"name":"Anaesthesiology Department, La Fe University and Polytechnic Hospital, Av. de Fernando Abril Martorell, 106, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismael","family":"Huertas","sequence":"additional","affiliation":[{"name":"Boston Scientific Neuromodulation Research (NRAC), 25155 Rye Canyon Loop, Valencia, CA 91355, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Peraita-Costa","sequence":"additional","affiliation":[{"name":"Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de Val\u00e8ncia, Av. Vicent Andr\u00e9s Estell\u00e9s s\/n, 46100 Burjassot, Spain"},{"name":"CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute (ISCIII), Av. Monforte de Lemos, 3-5, Pabell\u00f3n 11, Planta 0, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0785-1492","authenticated-orcid":false,"given":"Mar\u00eda","family":"Morales-Suarez-Varela","sequence":"additional","affiliation":[{"name":"Research Group in Social and Nutritional Epidemiology, Pharmacoepidemiology and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de Val\u00e8ncia, Av. Vicent Andr\u00e9s Estell\u00e9s s\/n, 46100 Burjassot, Spain"},{"name":"CIBER of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute (ISCIII), Av. Monforte de Lemos, 3-5, Pabell\u00f3n 11, Planta 0, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"ref_1","unstructured":"(2024, May 23). National Institute of Neurological Disorders and Stroke Peripheral Neuropathy, Available online: https:\/\/www.ninds.nih.gov\/health-information\/disorders\/peripheral-neuropathy."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1055\/s-0030-1267282","article-title":"Unusual peripheral neuropathies. Part I: Extrinsic causes","volume":"Volume 30","author":"Grantz","year":"2010","journal-title":"Seminars in Neurology"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Nolano, M., Tozza, S., Caporaso, G., and Provitera, V. (2020). Contribution of skin biopsy in peripheral neuropathies. 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