{
  "abstract": "Background The efficacy of spinal cord stimulation (SCS) in chronic pain studies is traditionally assessed by pain scores, which do not reflect the multidimensional nature of pain perception. Despite the evidence of SCS’s influence on emotional functioning comprehensive assessments of its effect remain lacking.Objective To assess changes in emotional and psychosocial functioning in patients who underwent SCS implantation for chronic pain.Evidence review Ovid MEDLINE, EMBASE, PsychINFO, Cochrane CENTRAL and Scopus databases were searched for original peer-reviewed publications reporting emotional functioning after SCS. The primary outcomes were a pooled mean difference (MD) in anxiety, depression, global functioning, mental well-being and pain catastrophizing at 12 months. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to determine the quality of evidence.Findings Thirty-two studies were included in the primary analysis. Statistically significant improvements were observed in anxiety (MD −2.16; 95% CI −2.84 to −1.49; p<0.001), depression (MD −4.66; 95% CI −6.26 to −3.06; p<0.001), global functioning (MD 20.30; 95% CI 14.69 to 25.90; p<0.001), mental well-being (MD 4.95; 95% CI 3.60 to 6.31; p<0.001), and pain catastrophizing (MD −12.09; 95% CI −14.94 to −9.23; p<0.001). Subgroup analyses revealed differences in Global Assessment of Functioning and mental well-being based on study design and in depression based on waveform paradigm.Conclusion The results highlight the statistically and clinically significant improvements in emotional and psychosocial outcomes in patients with chronic pain undergoing SCS therapy. However, these results need to be interpreted with caution due to the very low certainty of evidence per the GRADE criteria.PROSPERO registration CRD42023446326.",
  "authors": [
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Johana Klasova"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"
      ],
      "name": "Nasir Hussain"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, St Joseph's University Medical Center, Paterson, New Jersey, USA"
      ],
      "name": "Ibrahim Umer"
    },
    {
      "affiliations": [
        "Royal College of Surgeons in Ireland Medical University of Bahrain, Al Muharraq, Bahrain"
      ],
      "name": "Ahmed Al-Hindawi"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Mariam ElSaban"
    },
    {
      "affiliations": [
        "Department of Hematology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Simmy Lahori"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Ryan S D'Souza"
    }
  ],
  "title": "Emotional and psychosocial function after dorsal column spinal cord stimulator implantation: a systematic review and meta-analysis",
  "uid": "624ea8c1-dcfb-5d20-982b-16fb8c79a68d"
}