—Martin Leung FEBRUARY 8, 2016
A new technique that uses the principles of quantum mechanics can help some patients with peripheral neuropathy (PN) regenerate destroyed nerves, a recent study suggests.
There are approximately 23 million people in the United States affected by PN: numbness, weakness or pain caused by peripheral nerve damage, according to Peter M. Carney, MD, lead study author and a private practice neurosurgeon based in Elkhart, Ind. Dr. Carney said pharmaceuticals are currently the standard of care for PN, but some studies have shown that “even the best medications help less than half of the people who have pain,” and these patients are at risk for adverse side effects.
“This study shows that combining the principles of quantum mechanics in a technique called combined electrochemical therapy (CET), which combines electronic signaling treatment with injections of local anesthetics to have dramatic improvement both clinically and, more importantly, anatomically,” Dr. Carney said. “As such, it offers a safe and effective alternative to the pharmacology techniques we are currently using.”
The researchers conducted this prospective study to determine whether CET can help regenerate nerves destroyed by neuropathy. The study included 41 patients (average age, 68.5 years; 24 men). CET consists of twice-weekly injections of a local anesthetic near three sites at a patient’s feet: the sural nerves, the superficial and deep peroneal nerves, and the posterior tibial and saphenous nerves, followed by 15 to 30 minutes of electronic signaling. The electronic signaling system used has anti-inflammatory effects that can help repair cell membranes, increase blood flow and support the immune system, according to the researchers. Patients will receive up to 24 treatments but may stop sooner when they achieve a steady state of improvement.
“The ending point is that at 24 times, this is as good as you’re going to get. However, if the patient is doing better, we stop before then,” Dr. Carney said.
A patient also may be stopped from further treatment if he or she does not show a response by the sixth treatment, Dr. Carney noted. Most patients in this study averaged 17 treatments.
All patients received an epidermal nerve fiber density biopsy—the “gold standard” for PN diagnosis—at the beginning of treatment and at three to eight months after their last treatment. The primary outcome was nerve fiber growth and change in visual analog scale (VAS).
There were 116 biopsy sites in the study. The researchers identified 47 (40.5%) “positive biopsy sites,” defined by some regeneration of nerves.
“Of the 41 patients in this study, 30 (73%) of them showed there was some regrowth of the nerves. Twenty-five of them showed there was greater than 25% regrowth of the nerves. A good 35% showed there was more than a 100% growth of the nerves,” Dr. Carney said.
The average growth was 1.5 nerve fibers per millimeter for each positive site (3.0 nerve fibers per millimeter vs. 4.5 after the final CET treatment). One 65-year-old female diabetic patient even experienced complete nerve regrowth after 16 CET sessions.
“The initial biopsy showed she had no nerves in her skin, and was clinically severely impaired. Six months later, she had a normal number of nerves and her pain had gone from a 9 to a 2, and her function had improved markedly,” Dr. Carney said.
This patient’s post-CET biopsy was 3.4 nerves per millimeter versus zero in her initial biopsy.
The researchers found that VAS scores decreased by an average of 5.6 points (75%): from 7.5 (2-10) to 1.9 (0-8).
Dr. Carney said the most exciting finding from this study was the absence of adverse events. He conducted a prior study with 98 patients to test the efficacy of CET for reducing PN pain.
“Of a total of over 1,700 injections, there were two adverse side effects. One patient developed some blisters where the electrodes were and one 91-year-old felt faint while he was getting the injections,” he said. “In this study of 41 patients, there were no adverse side effects.”
Dr. Carney said the findings suggest that CET is a safe and effective treatment option for PN. He said more research is needed to validate the results from this study. The findings were presented at the 2015 annual meeting of the American Academy of Pain Management.
Dr. Carney reported no relevant financial disclosures.
http://www.painmedicinenews.com/Multimedia/Article/02-16/Novel-Treatment-Can-Regenerate-Nerves-Damaged-by-Peripheral-Neuropathy/35201
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