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Updated: Jan 27, 2026

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Paresthesia-Free Dorsal Root Ganglion Stimulation: An ACCURATE Study Sub-Analysis.

Nagy Mekhail1, Timothy R Deer2, Jeffery Kramer3

  • 1Evidence-based Pain Management Research Department, Cleveland Clinic, Cleveland, OH, USA.

Neuromodulation : Journal of the International Neuromodulation Society
|March 13, 2019
PubMed
Summary

Dorsal root ganglion (DRG) stimulation can provide effective pain relief without paresthesia for chronic lower extremity pain. Some patients achieved paresthesia-free analgesia, demonstrating it

Keywords:
Chronic neuropathic paincomplex regional pain syndromedorsal root ganglion stimulationpain reliefparesthesia-free analgesia

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Area of Science:

  • Neurology
  • Pain Management
  • Medical Devices

Background:

  • Dorsal root ganglion (DRG) stimulation is a safe and effective therapy for chronic lower extremity pain in complex regional pain syndrome (CRPS) types I and II.
  • The ACCURATE trial demonstrated DRG stimulation's efficacy, with adjustable programming to minimize paresthesia while maintaining pain relief.

Purpose of the Study:

  • To explore treatment outcomes for DRG stimulation subjects who were paresthesia-free versus those who experienced paresthesia.
  • To identify factors predicting paresthesia-free analgesia in DRG stimulation therapy.

Main Methods:

  • Retrospective analysis of 61 subjects from the ACCURATE study who received a permanent DRG neurostimulator.
  • Comparison of outcomes between paresthesia-free and paresthesia-present groups at multiple follow-up intervals (1, 3, 6, 9, 12 months).
  • Exploration of predictor variables for paresthesia presence or absence during DRG stimulation.

Main Results:

  • The proportion of subjects achieving paresthesia-free pain relief increased from 16.4% at 1 month to 38.3% at 12 months.
  • Paresthesia-free subjects showed similar or improved outcomes in pain severity, pain interference, quality of life, and mood compared to those with paresthesia.
  • Higher stimulation amplitudes, frequencies, more implanted leads, and younger age were associated with an increased likelihood of experiencing paresthesia.

Conclusions:

  • Effective paresthesia-free analgesia is achievable with DRG stimulation in some patients.
  • Paresthesia is not a prerequisite for pain relief and may not be necessary for optimal analgesia with DRG stimulation.