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1. Differential target multiplexed spinal cord stimulation in patients with Persistent Spinal Pain Syndrome Type II: a study protocol for a 12-month multicentre cohort study (DETECT)

Author

Philippe De Vloo, Maxime Billot, Sam Eldabe, Anaïs Van Hoylandt, Manuel Roulaud, Philippe Rigoard, Mark Plazier, Lisa Goudman, Maarten Moens, Tom Theys, Ann De Smedt, Bart Billet, Dimitri Vanhauwaert, Pieter-Jan Germonpré, Jeroen Ceuppens, Christ Declerck, Hannie Braems, Johan Vangeneugden, Bart Bryon, Thibault Remacle, Raf Van Paesschen, Sofie Denkens, Laura Verschueren, Vincent Raymaekers, Jean-Pierre Van Buyten, Iris Smet, Ali Jerjir, Michel Turlot, Stefaan Goossens, Patricia Da Silva, Ella Ver Donck, and Mayken Gorissen

Subjects
Medicine
Abstract

Introduction Differential target multiplexed spinal cord stimulation (DTM SCS) is a new stimulation paradigm for chronic pain management with the aim of modulating glial cells and neurons in order to rebalance their interactions. Animal studies revealed positive effects of this type of stimulation; however, studies in humans are still scarce, pointing towards the need for an evaluation of the effectiveness and safety of DTM SCS in clinical settings. Furthermore, the differential target multiplexed (DTM) algorithm consists of a combination of several programmes, which will presumably consume more energy from the spinal cord stimulation (SCS) battery. Therefore, the objective of DETECT is to investigate the feasibility, effectiveness and safety of DTM SCS in patients with Persistent Spinal Pain Syndrome Type II through a longitudinal cohort study.Methods and analysis DETECT is a prospective multicentre cohort study (n≥250) with a follow-up until 12 months after receiving DTM SCS. The study initiated in October 2021 and is currently still recruiting patients. Self-reporting outcome variables were evaluated at baseline (before SCS) and at 1, 6 and 12 months of DTM SCS. The primary effectiveness endpoint is overall pain intensity, measured with the visual analogue scale. Secondary effectiveness outcome measures are back pain intensity, leg pain intensity, disability, health-related quality of life, pain medication use, functional disability, clinical holistic responder status, self-management, impression of change, work status, pain catastrophising, symptoms of central sensitisation, anxiety, depression and healthcare utilisation. Time spent in different body postures and SCS stimulation parameters will be read out from the pulse generator. The prevalence of technical issues, recharge frequency, (serious) adverse events and the proportion of successful DTM trials will be collected as well. Longitudinal mixed models will be calculated to evaluate the effectiveness of DTM SCS over time.Ethics and dissemination The study protocol was approved by the central Ethics Committee of the Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (B.U.N.1432021000563) and the Ethics Committees of each participating centre. Research findings will be disseminated to key stakeholders through peer-reviewed publications in scientific journals and presentations to clinical audiences.Trial registration number NCT05068011.

Published
2024
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2. A randomized controlled trial comparing conservative versus surgical treatment in patients with foot drop due to peroneal nerve entrapment: results of an internal feasibility pilot study

Author

Christophe Oosterbos, Sofie Rummens, Kris Bogaerts, Anaïs Van Hoylandt, Sophie Hoornaert, Frank Weyns, Annie Dubuisson, Jeroen Ceuppens, Sophie Schuind, Justus L Groen, Robin Lemmens, and Tom Theys

Subjects
Randomized controlled trial, Foot drop, Peroneal nerve, Neurolysis, Conservative treatment, Feasibility, Medicine (General), R5-920
Abstract

Abstract Background Based on the lack of literature to support any treatment strategy in patients with foot drop due to peroneal nerve entrapment, a prospective study randomizing patients between surgery and conservative treatment is warranted. Since studies comparing surgery to no surgery are often challenging, we first examined the feasibility of such a randomized controlled trial. Methods/design An internal feasibility pilot study was conducted to assess several aspects of process, resource, management, and scientific feasibility. The main objective was the assessment of the recruitment rate. The criterion to embark on a full study was the recruitment of at least 14 patients in 6 participating centers within 6 months. Cross-over rate, blinding measures, training strategies, and trial assessments were evaluated. The trial was entirely funded by the KCE Trials public funding program of the Belgian Health Care Knowledge Centre (ID KCE19-1232). Results The initial duration was prolonged due to the COVID-19 pandemic. Between April 2021 and October 2022, we included 19 patients of which 15 were randomized. Fourteen patients were treated as randomized. One drop-out occurred after randomization, prior to surgery. We did not document any cross-over or accidental unblinding. Training strategies were successful. Patients perceived the quality of life questionnaire as the least relevant assessment. Assessment of ankle dorsiflexion range of motion was prone to interobserver variability. All other trial assessments were adequate. Discussion Recruitment of the anticipated 14 patients was feasible although slower than expected. The Short-Form Health Survey (SF-36) and assessment of ankle dorsiflexion range of motion will no longer be included in the full-scale FOOTDROP trial. Conclusion The FOOTDROP study is feasible. Trial registration ClinicalTrials.gov, identifier NCT04695834 . Registered 4 January 2021.

Published
2023
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3. Generalization of fear of movement-related pain and avoidance behavior as predictors of work resumption after back surgery: a study protocol for a prospective study (WABS)

Author

Rini Masuy, Lotte Bamelis, Katleen Bogaerts, Bart Depreitere, Kris De Smedt, Jeroen Ceuppens, Bert Lenaert, Sarah Lonneville, Dieter Peuskens, Johan Van Lerbeirghe, Patrick Van Schaeybroeck, Peter Vorlat, Steefka Zijlstra, Ann Meulders, and Johan W. S. Vlaeyen

Subjects
Low back pain, Back surgery, Postoperative pain, Predictors of return to work, Fear of movement-related pain, Avoidance, Psychology, BF1-990
Abstract

Abstract Background Previous studies indicated that about 20% of the individuals undergoing back surgery are unable to return to work 3 months to 1 year after surgery. The specific factors that predict individual trajectories in postoperative pain, recovery, and work resumption are largely unknown. The aim of this study is to identify modifiable predictors of work resumption after back surgery. Methods In this multisite, prospective, longitudinal study, 300 individuals with radicular pain undergoing a lumbar decompression will be followed until 1-year post-surgery. Prior to surgery, participants will perform a computer task to assess fear of movement-related pain, avoidance behavior, and their generalization to novel situations. Before and immediately after surgery, participants will additionally complete questionnaires to assess fear of movement-related pain, avoidance behavior, optimism, expectancies towards recovery and work resumption, and the duration and severity of the pain. Six weeks, 3 months, 6 months, and 12 months after surgery, they will again complete questionnaires to assess sustainable work resumption, pain severity, disability, and quality of life. The primary hypothesis is that (generalization of) fear of movement-related pain and avoidance behavior will negatively affect sustainable work resumption after back surgery. Second, we hypothesize that (generalization of) fear of movement-related pain and avoidance behavior, negative expectancies towards recovery and work resumption, longer pain duration, and more severe pain before the surgery will negatively affect work resumption, pain severity, disability, and quality of life after back surgery. In contrast, optimism and positive expectancies towards recovery and work resumption are expected to predict more favorable work resumption, better quality of life, and lower levels of pain severity and disability after back surgery. Discussion With the results of this research, we hope to contribute to the development of strategies for early identification of risk factors and appropriate guidance and interventions before and after back surgery. Trial registration The study was preregistered on ClinicalTrials.gov: NCT04747860 on February 9, 2021.

Published
2022
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4. Intracranial Solitary Fibrous Tumour

Author

Eveline Claus, Patrick Seynaeve, Jeroen Ceuppens, Alain Vanneste, and Koenraad Verstraete

Subjects
intracranial, solitary, fibrous, tumour, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Solitary fibrous tumours are rare mesenchymal spindle-cell tumours that occur most often in the visceral pleura or liver. If they occur intracranially, they are extra-axially located and develop from the meninges. In those cases, the differential diagnosis has to be made with other intracranial extra-axial-located tumours, such as meningeoma and hemangiopericytoma. We report a 32-year-old woman with an intracranial solitary fibrous tumour and review the latest literature regarding the imaging characteristics of this tumour.

Published
2017
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5. Evidence in peroneal nerve entrapment: A scoping review

Author

Christophe Oosterbos, Lukas Rasulić, Johannes van Loon, Frank Weyns, Robin Lemmens, Tom Theys, Thomas Decramer, Annie Dubuisson, Sofie Rummens, Justus L. Groen, Sophie Schuind, and Jeroen Ceuppens

Subjects
medicine.medical_specialty, Foot drop, MEDLINE, Cochrane Library, Neurosurgical Procedures, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, medicine, Humans, 030212 general & internal medicine, Peroneal Neuropathies, Neurolysis, Ultrasonography, medicine.diagnostic_test, business.industry, Ultrasound, Magnetic resonance imaging, Magnetic Resonance Imaging, 3. Good health, Compound muscle action potential, Treatment Outcome, Neurology, Neurology (clinical), Radiology, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Background and purpose Daily management of patients with foot drop due to peroneal nerve entrapment varies between a purely conservative treatment and early surgery, with no high-quality evidence to guide current practice. Electrodiagnostic (EDX) prognostic features and the value of imaging in establishing and supplementing the diagnosis have not been clearly established. Methods We performed a literature search in the online databases MEDLINE, Embase, and the Cochrane Library. Of the 42 unique articles meeting the eligibility criteria, 10 discussed diagnostic performance of imaging, 11 reported EDX limits for abnormal values and/or the value of EDX in prognostication, and 26 focused on treatment outcome. Results Studies report high sensitivity and specificity of both ultrasound (varying respectively from 47.1% to 91% and from 53% to 100%) and magnetic resonance imaging (MRI; varying respectively from 31% to 100% and from 73% to 100%). One comparative trial favoured ultrasound over MRI. Variable criteria for a conduction block (>20%-≥50) were reported. A motor conduction block and any baseline compound motor action potential response were identified as predictors of good outcome. Based predominantly on case series, the percentage of patients with good outcome ranged 0%-100% after conservative treatment and 40%-100% after neurolysis. No study compared both treatments. Conclusions Ultrasound and MRI have good accuracy, and introducing imaging in the standard diagnostic workup should be considered. Further research should focus on the role of EDX in prognostication. No recommendation on the optimal treatment strategy of peroneal nerve entrapment can be made, warranting future randomized controlled trials.

Published
2021
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6. Spinal Cord Stimulation-Naïve Patients vs Patients With Failed Previous Experiences With Standard Spinal Cord Stimulation: Two Distinct Entities or One Population?

Author

Lisa Goudman, Philippe Rigoard, Maxime Billot, Ann De Smedt, Manuel Roulaud, Discover Consortium, Maarten Moens, Tom Eykens, Kelly De Keersmaecker, Mayken Gorissen, Christ De Clerck, Ann Ver Donck, Hannie Braems, Klaas Buyse, Martine Puylaert, Wim Duyvendak, Chris De Smet, Steven Vissers, Johan Debeuf, Kim De Beucker, Jeroen Ceuppens, Pieter Jan Germonpré, Sarah Mortier, Jean Pierre Van Buyten, Iris Smet, Marieke Devos, Dimitri Vanhauwaert, Bart Billet, Karel Hanssens, Annemarie Demeyere, Tine Casier, Bénédicte Bertrem, Tony Van Havenbergh, Pieter Van Looy, Gertje Heylen, Catherine de Schryver, Johan Vangeneugden, Frédéric Louis, Virginie Stalmans, Jean- Michel Remacle, Thibault Remacle, Stéphane Mauviel, Laurence Abeloos, Tom Theys, Anaïs Van Hoylandt, Dominike Bruyninckx, John Das, Ina Callebaut, Bertille Lorgeoux, Mats De Jaeger, Alexis Valenzuela Espinoza, Robbert-Jan Van Hooff, Supporting clinical sciences, Neurosurgery, Pain in Motion, UZB Other, Physical Medicine and Rehabilitation, Clinical sciences, Neuroprotection & Neuromodulation, and Radiology

Subjects
Machine Learning, persistent spinal pain syndrome type 2, surgery, Anesthesiology and Pain Medicine, Neurology, Neuroscience(all), Discriminant Analysis, Physical Therapy, Sports Therapy and Rehabilitation, Neurology (clinical), General Medicine, failed back surgery syndrome, clustering
Abstract

INTRODUCTION: Nowadays, the success of spinal cord stimulation (SCS) is evaluated separately in patients who have previous experiences with standard SCS and in SCS-naïve patients. Nevertheless, it is yet to be evaluated whether both patient groups are effectively distinct patient groups. Therefore, the aims of this study are twofold: 1) Are there clusters in the data to distinguish between both patient groups? 2) Can we discriminate both patient groups based on routinely collected clinical parameters? MATERIALS AND METHODS: Baseline data from the Discover study were used, in which 263 patients with persistent spinal pain syndrome type 2 were included (185 neurostimulation-naïve patients and 78 patients with previous SCS experience). Pain intensity scores for low back and leg pain, functional disability, medication use, and health-related quality of life utility scores were used in the analysis. Model-based clustering was performed on standardized data. Discriminant analysis was performed with linear and quadratic discriminant analysis, with leave-one-out cross-validation to evaluate model performance. RESULTS: Model-based clustering revealed two different clusters in the data. None of the clusters clearly separated SCS-naïve patients from patients with previous SCS experience. Linear discriminant analysis resulted in a leave-one-out cross-validation error rate of 30.0% to discriminate between both patient groups, based on routinely collected clinical parameters. CONCLUSIONS: Clustering analysis did not result in clusters that separate SCS-naïve patients from patients with previous SCS experience. This may suggest that both patient groups should not be considered as two different patient groups when comparing them on routine clinical parameters, with potentially profound implications for research and clinical settings. CLINICAL TRIAL REGISTRATION: The Clinicaltrials.gov registration number for the Discover study is NCT02787265.

Published
2021

8. Contributors

Author

Khalid M. Abbed, Kalil G. Abdullah, Paul D. Ackerman, Yunus Alapan, Vincent J. Alentado, Matthew D. Alvin, Christopher P. Ames, Neel Anand, Paul A. Anderson, Lilyana Angelov, Alireza K. Anissipour, John A. Anson, Ronald I. Apfelbaum, Michael Archdeacon, Paul M. Arnold, Mike W.J. Arun, Harel Arzi, Ahmed J. Awad, Basem I. Awad, Biji Bahuleyan, Mark D. Bain, Lissa C. Baird, Jamie Baisden, Nevan G. Baldwin, Perry A. Ball, Karl E. Balsara, Eli M. Baron, H. Hunt Batjer, Andrew M. Bauer, Thomas W. Bauer, Joshua M. Beckman, Gordon R. Bell, Carlo Bellabarba, E. Emily Bennett, Edward C. Benzel, Darren L. Bergey, Tarun Bhalla, Karin S. Bierbrauer, Mark Bilsky, Harjus Birk, Erica F. Bisson, Christopher Bono, Richard J. Bransford, Darrel S. Brodke, Nathaniel Brooks, Cristian Brotea, Jared R. Brougham, Samuel R. Browd, Robert T. Buckley, Shane Burch, John Butler, Mohamad Bydon, Steven Casha, Jeroen Ceuppens, Andrew K. Chan, Thomas C. Chen, Joseph Cheng, Dean Chou, Tanvir Choudhri, Aaron J. Clark, Adam M. Conley, Paul R. Cooper, Domagoj Coric, Mark Corriveau, Ian P. Côté, Jean-Valery C.E. Coumans, Charles H. Crawford, William T. Curry, Scott D. Daffner, Sedat Dalbayrak, Russell C. DeMicco, Harel Deutsch, Sanjay S. Dhall, Denis J. DiAngelo, Curtis A. Dickman, Shah-Nawaz M. Dodwad, Siena M. Duarte, Zeyd Ebrahim, Gerald W. Eckardt, Bruce L. Ehni, Kurt M. Eichholz, Marc Eichler, Samer K. Elbabaa, Benjamin D. Elder, James B. Elder, Richard G. Ellenbogen, Nancy Epstein, Thomas J. Errico, Yoshua Esquenazi, Daniel K. Fahim, Ehab Farag, Chad W. Farley, Michael G. Fehlings, Frank Feigenbaum, Eoin Fenton, Lisa A. Ferrara, R. David Fessler, Richard G. Fessler, Michael A. Finn, Ryan Finnan, Jeffrey S. Fischgrund, Kevin T. Foley, Ricardo B.V. Fontes, Todd B. Francis, Brett A. Freedman, Frederick Frost, John George, John W. German, Peter C. Gerszten, George M. Ghobrial, Zoher Ghogawala, Justin L. Gibson, Christopher C. Gillis, Vijay K. Goel, Jan Goffin, Ziya L. Gokaslan, Sohrab Gollogly, C. Rory Goodwin, Carlos R. Goulart, Vadim Goz, Yair M. Gozal, Randall B. Graham, Gerald A. Grant, Jian Guan, Ilker Gulec, Yazeed M. Gussous, Richard D. Guyer, David Gwinn, Sung Ha, Eldad Hadar, Clayton L. Haldeman, Alexander Y. Halim, Kimberly M. Hamilton, Christine L. Hammer, Fadi Hanbali, Shannon W. Hann, Jurgen Harms, James S. Harrop, Blaine L. Hart, David J. Hart, Daniel Harwell, Reyaad A. Hayek, Robert F. Heary, Fraser C. Henderson, Patrick W. Hitchon, Daniel J. Hoh, Paul J. Holman, Noboru Hosono, Clifford Houseman, John K. Houten, Joseph C. Hsieh, Wellington K. Hsu, Meng Huang, R. John Hurlbert, Lee Hwang, Steven Hwang, Serkan İnceoğlu, Libby Kosnik Infinger, Tatiana von Hertwig Fernandes de Oliveira, Devesh Jalan, Neilank Jha, J. Patrick Johnson, Charles I. Jones, G. Alexander Jones, Michael Jones, Rupa G. Juthani, Christopher D. Kager, Maziyar A. Kalani, M. Yashar S. Kalani, Iain H. Kalfas, Ricky R. Kalra, Reza J. Karimi, Osama Kashlan, Manish K. Kasliwal, Vikas Kaul, Mayank Kaushal, Tyler J. Kenning, Saad Khairi, Tagreed Khalaf, Jad G. Khalil, Larry T. Khoo, Ali Kiapour, Daniel H. Kim, David H. Kim, Kristopher T. Kimmell, Steven Kirshblum, Sameer A. Kitab, Paul Klimo, Eric O. Klineberg, Tyler R. Koski, Thomas A. Kosztowski, Robert J. Kowalski, Ajit A. Krishnaney, Kelly Krupa, Kristin Krupa, Varun R. Kshettry, Sunil Kukreja, Charles Kuntz, Shekar N. Kurpad, Srinivasu Kusuma, Michael LaBagnara, Frank La Marca, Ilya Laufer, Elizabeth Demers Lavelle, William F. Lavelle, W. Thomas Lawrence, Darren R. Lebl, Bryan S. Lee, Sun-Ho Lee, Lawrence G. Lenke, Steven P. Leon, Amy Li, Yiping Li, Isador H. Lieberman, James K.C. Liu, Victor P. Lo, S. Scott Lollis, Miguel Lopez-Gonzalez, Daniel Lubelski, Mark G. Luciano, Andre G. Machado, Raghu Maddela, Ravichandra A. Madineni, Casey Madura, Dennis J. Maiman, David G. Malone, Antonios Mammis, Satyajit Marawar, Nicolas Marcotte, Joseph C. Maroon, Michael D. Martin, Eduardo Martinez-del-Campo, Eric M. Massicotte, Tobias A. Mattei, Paul K. Maurer, Eric A.K. Mayer, Miguel Mayol del Valle, Daniel J. Mazanec, Paul C. McCormick, William McCormick, Zachary A. Medress, Ehud Mendel, Umesh S. Metkar, Vincent J. Miele, Ahmed Mohyeldin, Jad Bou Monsef, Timothy A. Moore, Hikaru Morisue, Peter Morone, Thomas E. Mroz, Jeffrey P. Mullin, F. Reed Murtagh, Ryan D. Murtagh, Sait Naderi, Usha D. Nagaraj, Charles C. Nalley, Anil Nanda, Richard J. Nasca, Anick Nater, Matthew T. Neal, Russ P. Nockels, John A. Norwig, Solomon M. Ondoma, Akinwunmi Oni-Orisan, Jonathan H. Oren, Jennifer Orning, R. Douglas Orr, Katie Orrico, Joseph A. Osorio, Ernesto Otero-Lopez, John O'Toole, Paul Park, Vikas Parmar, Robert S. Pashman, Rakesh D. Patel, Smruti K. Patel, Mick J. Perez-Cruet, Noel I. Perin, David B. Pettigrew, H. Westley Phillips, Rick Placide, Paul Porensky, Joshua P. Prager, Srinivas Prasad, Mark L. Prasarn, Rakesh Ramakrishnan, Ashwin G. Ramayya, Y. Raja Rampersaud, Peter A. Rasmussen, John K. Ratliff, Wolfgang Rauschning, Glenn R. Rechtine, Pablo F. Recinos, Daniel K. Resnick, Jay Rhee, Laurence D. Rhines, Alexander R. Riccio, Marlin Dustin Richardson, Bertram Richter, Ron Riesenburger, K. Daniel Riew, Matthew Rogers, Fanor M. Saavedra, Mina G. Safain, Rajiv Saigal, Paul D. Sawin, Justin K. Scheer, Joshua Scheidler, David W. Schippert, Richard Schlenk, Bradley Schmidt, Meic H. Schmidt, Daniel M. Sciubba, Christopher I. Shaffrey, Mark E. Shaffrey, Anoli Shah, Alok Sharan, Ashwini D. Sharan, Daniel Shedid, Steven Shook, Michael P. Silverstein, Venita M. Simpson, Anthony Sin, Harminder Singh, Donald A. Smith, Gabriel A. Smith, Justin S. Smith, Kyle A. Smith, Volker K.H. Sonntag, Hector Soriano-Baron, Robert F. Spetzler, W. Ryan Spiker, Blake Staub, Michael P. Steinmetz, Charles B. Stillerman, Andrea Strayer, Gandhivarma Subramaniam, Hamdi G. Sukkarieh, Andrew Sumich, Derrick Y. Sun, Tarek P. Sunna, Durga R. Sure, Richard A. Tallarico, Lee A. Tan, Claudio E. Tatsui, Fernando Techy, Nicholas Theodore, Alexander A. Theologis, Nicholas W.M. Thomas, Brian D. Thorp, Scott Tintle, Stavropoula Tjoumakaris, William D. Tobler, Daisuke Togawa, David Traul, Vincent C. Traynelis, A. Sophia Tritle, Gregory R. Trost, Eve C. Tsai, Kene Ugokwe, Kutlauy Uluc, Juan S. Uribe, Alexander R. Vaccaro, Alex Valadka, Aditya Vedantam, Anand Veeravagu, Kushagra Verma, Todd Vitaz, Jean-Marc Voyadzis, Scott Wagner, Trevor C. Wahlquist, Robert Waldrop, Kevin M. Walsh, Jeffrey C. Wang, Michael Y. Wang, Patrick T. Wang, John D. Ward, Zabi Wardak, Connor Wathen, Philip R. Weinstein, Michael Weisman, William C. Welch, Simcha J. Weller, L. Erik Westerlund, Jonathan A. White, Robert G. Whitmore, Jack E. Wilberger, Kim A. Williams, Ethan A. Winkler, Christopher D. Witiw, Christopher E. Wolfla, Jean-Paul Wolinsky, Cyrus Wong, Eric J. Woodard, Vijay Yanamadala, Daniel S. Yanni, Philip A. Yazbak, Chun-Po Yen, Mesut Yilmaz, Narayan Yoganandan, Kenneth S. Yonemura, Kazuo Yonenobu, Hansen A. Yuan, John K. Yue, Adam M. Zanation, Salvatore M. Zavarella, Seth M. Zeidman, Mehmet Zileli, Scott Zuckerman, and Holly Zywicke

Published
2017
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9. Brainstem glioma in adults: is tissue the issue?

Author

J Menten, Jan Goffin, F. Van Calenbergh, M. Van Der Sanden, and Jeroen Ceuppens

Subjects
Radiation therapy, Pathology, medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Biopsy, medicine, Brainstem glioma, Surgery, Neurology (clinical), medicine.disease, business
Published
2009
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