Fig. 12

The Current literature supports multiple domains of MOA of SCS. Major P-SCS, PF-SCS and DRG-S analgesic MOA include modulation of 1) segmental and supraspinal neurotransmitters, 2) segmental and supraspinal neurophysiology/neuroplasticity, 3) central and peripheral neuroinflammation and 4) cortical and subcortical neurocircuits. P-SCS has accrued the largest literature in support of all four MOA, while only P-SCS preclinical studies consistently demonstrate modulation of neurotransmitters critical to analgesia. Emerging and published literature support the concept that all SCS paradigms (P-SCS, B-SCS, DRG-S, HF-SCS, ECAP-SCS) contribute to altered neuronal activity (i.e. neurophysiological). Pre-clinical and clinical work support cortical SCS paradigms (P-SCS, B-SCS, DRG-S, HF-SCS, ECAP-SCS) contribute to altered neurocircuit activity