Magnetic Peripheral Nerve Stimulation Shows Superior Results for Chronic Neuropathic Pain Relief

Leonardo Kapural, MD, PhD

Credit: Center for Clinical Research

Chronic neuropathic pain, often caused by trauma or surgery, is hard to treat with current methods that can have side effects and inconsistent results.

A recent study evaluated a new, non-invasive treatment called magnetic peripheral nerve stimulation (mPNS), combined with standard medical care, to see if it could provide better pain relief. Over a 90-day period, patients who received mPNS alongside regular care experienced significantly more pain relief compared to those who only received regular care.

mPNS, a non-painful procedure, provides effective pain relief without side effects. It is applied in 13.33-minute sessions, with three sessions in the first week, weekly sessions in weeks two through four, followed by bi-weekly sessions in weeks five through 13. It is believed that an increased rate of plasticity changes in the brain are observed due to motor activity in the ascending and descending pathways of PNS and central nervous system.

“There is a substantial clinical need for improved treatments for chronic neuropathic pain. Chronic neuropathic pain impacts most aspects of a person’s life, including emotional distress and/or social impairment,” wrote a team of investigators led by Leonardo Kapural, MD, PhD, pain physician at the Carolinas Pain Institute and The Center for Clinical Research. “Unfortunately, currently available treatments have limited effectiveness in most subjects with severe chronic pain.”

The randomized, controlled, multi-site clinical trial, the Safety and Efficacy of Axon Therapy (SEAT) Study, compared the long-term efficacy and safety of mPNS in combination with conventional medical management (CMM) among a cohort of 65 patients with post-traumatic, post-surgical neuropathy. Patients were randomized to the mPNS + CMM group or CMM alone and followed over a period of 90 days.

The primary endpoint was the percentage of responders achieving a 50% or greater reduction in pain at the end of the trial. Other endpoints of interest were the Patient Global Impression of Change (PGIC) and the European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L).

A total of 35 patients were placed in the intervention group and 30 were placed in the control group.

At the three-month mark, 71% of patients in the mPNS + CMM group were classified as responders with >50% pain relief compared with only 13% in the CMM group. Those receiving mPNS treatment had a mean reduction of visual analog scale (VAS) of 3.8 points compared with a less than 1-point reduction in the control cohort.

Additionally, the EQ-5D-3L score increased in the mPNS group while the controls exhibited no improvements at the end of the trial. PGIC responder rates were significantly higher in the mPNS group compared with the CMM groups (80.6% and 4.3%, respectively).

Adverse events were observed in 17.1% in the intervention group and 13.3% in the control group, although no adverse events led to withdrawal. Treatment-related adverse events included ankle pain and shoulder pain, but were not considered related to the procedure. Results indicate mPNS is a safe and effective option for managing chronic pain.

“Improvements in pain relief and quality-of-life after using mPNS therapy were significant and profound in SEAT Study,” investigators said. “This suggests that mPNS should be considered very early in the chronic pain treatment algorithm before any invasive procedure. Further assessment of cost-effectiveness of such intermittent therapy when compared with early treatments for neuropathic pain needs to be addressed in upcoming studies.”