The Effects of Spinal Cord Stimulation on Sleep, Quality of Life and Anxiety and Depressive Symptoms in Patients with Chronic Pain

Abstract

Objective: The aim of this study was to investigate whether spinal cord stimulation (SCS), a neuromodulation technique, causes any changes in sleep, quality of life, anxiety and depressive symptoms before and after the procedure in patients with chronic pain. Methods: The study was completed with 14 patients who were planned to undergo SCS for treatment-resistant chronic neuropathic pain and who applied to the psychiatry outpatient clinic for pre-treatment consultation. Patients were evaluated twice, before and 1 month after treatment. Patients were evaluated with LANNS Pain Scale, Hamilton Depression Scale (Ham-D), Hamilton Anxiety Scale (HAM-A), Pittzburg Sleep Quality Inventory (PUKI), and Quality of Life Scale Short Form (WHOQOL-Bref). Scale scores before and after the treatment were compared using a two-sample dependent t-test. Results: Depressive disorder was detected in 85.8% of the cases, anxiety disorder in 71.5%, and sleep disorder in 78.6%. The cases’ LANSS pain scale scores were 19.00±5.11 pre-treatment and 7.57±4.59 post-treatment, the difference being statistically significant (P=0.001). Significant differences were observed between pre- and post-test HAM-D, HAM-A, PSQI, quality of life (QoL) general health, QoL physical health, or QoL psychological health scores (P=.002, P=.014, P=.002, P=.002, P=.002, and P=.001, respectively). However, no significant differences were determined between pre- and post-test QoL social relationships or QoL environmental health scores (P=.160 and P=.831, respectively) Conclusion: Our data in this study suggest that SCS not only effectively reduces pain in treatment-resistant chronic pain, but also mediates significant improvements in sleep quality, anxiety and depressive states.