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Clinical Predictors of Pain Relief with 60-Day Peripheral Nerve Stimulation: A Multicenter Observational Study
Charles A Odonkor1, Oghenewoma Oghenesume2, Salman Hirani3
1Department of Orthopaedics and Rehabilitation, Division of Physiatry, Interventional Pain Medicine, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA.
Journal of Pain Research
|August 13, 2025
Summary
Predicting pain relief from 60-day peripheral nerve stimulation (PNS) is now clearer. High physical activity and self-efficacy predict early success, while psychological distress and obesity indicate non-response to PNS.
Area of Science:
- Neurology
- Pain Management
- Medical Devices
Background:
- Clinical predictors for successful pain relief using 60-day peripheral nerve stimulation (PNS) are not well-defined.
- Identifying factors associated with treatment outcomes is crucial for optimizing patient selection and improving results.
Purpose of the Study:
- To examine baseline physical activity, pain, disability, and psychological factors influencing early, delayed, and non-response to a 60-day PNS.
Main Methods:
- Prospective, multicenter, observational cohort study of 73 patients receiving 60-day PNS.
- Baseline assessments included pain (NRS), disability (ODI), psychological profiles (PSEQ, PCS), and physical activity (PAVS).
- Logistic regression and principal component analysis identified predictors of response phenotypes.
Main Results:
- Early responders (26%) and delayed responders (43%) were identified; non-responders comprised 30.1%.
- Predictors of early response: high physical activity, high pain self-efficacy, and low catastrophizing.
- Delayed response associated with longer pain duration and high baseline disability (ODI). Non-response linked to psychological distress, opioid dependency, and morbid obesity.
Conclusions:
- Baseline physical activity, psychological resilience, and pain behaviors predict response to 60-day PNS.
- Non-responders often exhibit psychological distress, morbid obesity, and opioid dependence.
- Findings can refine patient selection and manage treatment expectations for PNS therapy.
