Analysis of Selected Biochemical Parameters in Cerebrospinal Fluid and Peripheral Blood in the Treatment of Neuropathic Pain Using Spinal Cord Stimulation (SCS) Assessment of the Mechanism of Action of SCS and the Potential of Biochemical Studies in Therapy Planning and Monitoring

1. The Aim of the Project

The aim of this project is to measure the concentrations of selected inflammatory mediators and other signalling molecules in the blood and cerebrospinal fluid (CSF) of patients undergoing spinal cord stimulation (SCS). The goal is to identify which cells and molecules are crucial in the development of neuropathic pain and its treatment via SCS. This will provide insight into the mechanisms underlying SCS and enhance our understanding of how it works.

Additionally, the correlation between the concentrations of these molecules and patients' clinical status, treatment outcomes (whether successful or not), and especially blood concentrations of certain markers, may allow for the development of simple tools for predicting the response to a particular type of stimulation, monitoring treatment effectiveness, and identifying potential complementary pharmacotherapies.

Previous research conducted by my team, which forms the basis for this project, has shown that SCS affects iron and calcium metabolism and that different types of stimulation vary in their effectiveness in reducing pain. This variation may stem from the superiority of one method over another or from patient-specific factors, which this study aims to clarify. 2. Importance of the Project

SCS has been successfully used to treat neuropathic pain for over fifty years. Despite ongoing advancements-such as new devices and stimulation techniques-the exact mechanism of SCS remains unknown. Not only is it unclear which cells mediate pain signal inhibition, but even the precise target site of stimulation is still under debate. Genomic studies on animal models have so far failed to resolve this issue.