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Effects of spinal cord stimulation on heart rate variability in patients with Failed Back Surgery Syndrome

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  • Lisa Goudman
  • Raf Brouns
  • Bengt Linderoth
  • Maarten Moens

Abstract

Background: Building on the recent finding that chronic pain patients with impaired functioning of the descending nociceptive inhibitory system (DNIS) present lower resting heart rate variability (HRV), this study aims to investigate the impact of Spinal Cord Stimulation (SCS) on HRV in patients with Failed Back Surgery Syndrome (FBSS). More precisely, we hypothesize that SCS influences the DNIS, with increased parasympathetic tone as a consequence, as measurable by HRV analysis. Methods: Twenty-two patients diagnosed with FBSS and treated with SCS participated in this study. HRV was measured with a 2-lead ECG registration tool during on and off states of SCS. HRV analysis for time, frequency, time-frequency and nonlinear domain parameters was based on a 5-minute recording segment. Results: The mean heart rate and low frequency power were significantly lower when SCS was activated. HRV, absolute and normalized high frequency power significantly increased during SCS compared to without SCS. The ratio of low frequency/high frequency ratios, as parameter for global sympathetic-parasympathetic equilibrium, significantly decreased when SCS was activated. Conclusions: When SCS is switched off, patients with FBSS present relatively stronger sympathetic tone and weaker parasympathetic activity. Activation of the SCS, possibly via stimulation of the DNIS, restores this disbalance of autonomic activity.

Suggested Citation

  • Lisa Goudman & Raf Brouns & Bengt Linderoth & Maarten Moens, 2019. "Effects of spinal cord stimulation on heart rate variability in patients with Failed Back Surgery Syndrome," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-17, July.
    • Handle: RePEc:plo:pone00:0219076
    DOI: 10.1371/journal.pone.0219076
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    References listed on IDEAS

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    1. Laetitia Yperzeele & Robbert-Jan van Hooff & Ann De Smedt & Guy Nagels & Ives Hubloue & Jacques De Keyser & Raf Brouns, 2016. "Feasibility, Reliability and Predictive Value Of In-Ambulance Heart Rate Variability Registration," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-14, May.
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