Evidence map›Paper›PMID 42268376›Full record

ReviewPain medicine (Malden, Mass.)2026

Closed-loop SCS and sensing: now and in the future.

Krishnan Chakravarthy, Vwaire Orhurhu, Jan Willem Kallewaard, Leonardo Kapural, Alaa Abd-Elsayed, Yashar Eshraghi, Lakshmi Rekha Narra, Priyanka Ghosh, Samir Sheth, David W Lee and 5 more

Abstract readReview
In one paragraph

Review in Pain medicine (Malden, Mass.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Krishnan ChakravarthyVA San Diego Healthcare, San Diego, CA, United States.
Vwaire OrhurhuUniversity of Pittsburgh Medical Center, Williamsport, PA, United States.ORCID 0000-0002-2794-738X
Jan Willem KallewaardRijnstate Hospital, Department of Anesthesiology and Pain Management, Arnhem, Netherlands.
Leonardo KapuralCarolinas Pain Institute, Winston-Salem, NC, United States.ORCID 0000-0003-2718-5837
Alaa Abd-ElsayedUniversity of Wisconsin, Department of Anesthesia, Madison, WI, United States.
Yashar EshraghiOchsner Health System, Louisiana State University School of Medicine, New Orleans, LA, United States.
Lakshmi Rekha NarraRutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States.
Priyanka GhoshRemedy Medical Group, San Francisco, CA, United States.
Samir ShethSutter Health, Roseville, CA, United States.
David W LeeFullerton Orthopedic, University of California, Irvine, Fullerton, CA, United States.ORCID 0000-0001-6691-2764
Rajiv ReddyDepartment of Anesthesiology and Pain Medicine, University of California San Diego Health Sciences, San Diego, CA, United States.
Lisa M JohanekMedtronic Neuromodulation, Minneapolis, MN, United States.ORCID 0009-0002-1139-5282
Julia E GamacheMedtronic Neuromodulation, Minneapolis, MN, United States.ORCID 0000-0002-3750-147X
David A DinsmoorMedtronic Neuromodulation, Minneapolis, MN, United States.
AnneMarie K BrindaMedtronic Neuromodulation, Minneapolis, MN, United States.

Funding

Medtronic Neuromodulation
6 · The paper itself

Abstract

backgroundSpinal cord stimulation (SCS) for chronic pain has undergone many advancements over the years, including the introduction of novel stimulation waveforms, expansion to treat new pain conditions, and the more recent implementation of evoked compound action potential (ECAP) controlled, closed-loop (CL) SCS. The ECAP-a measure of neural activation-may be used as a biosignal for adjusting stimulation amplitudes to avoid under- and overstimulation associated with spinal cord movement relative to the SCS lead. CONTENT OVERVIEW: Using ECAPs in a CL system relies on successfully isolating the neural response signal from the relatively large stimulation artifact. A study with the first commercialized CL-SCS device investigated pain relief with low-frequency stimulation within a therapy window described as ranging from initial perception of sensation to discomfort (paresthesia window). In contrast, another commercial system with CL technology includes additional functionality to support consistent therapy with higher frequency stimulation set at or near the perception threshold. This more recently approved CL-SCS system leverages advanced artifact suppression and flexible CL control algorithms to afford dose control for conventional, high-frequency (up to 1200 Hz), and contemporary SCS waveforms.

conclusionsHere, we discuss the history and motivation for CL systems in SCS and the challenges faced when implementing such technology.

Indexed as

Chronic PainPain ManagementSpinal Cord StimulationAction PotentialsAnimalsEvoked PotentialsHumansSpinal Cordclosed loop SCSevoked compound action potentialspinal cordspinal cord stimulation

Identifiers

PMID42268376
PMCPMC13250572

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.