Dorsal root ganglion neurostimulation: a target for treatment for intractable neuropathic itch?

Abstract

Intractable itch is a severe, relentless, and debilitating chronic itch that is not curable by any known means. Ordinary medical measures usually are not helpful for these patients who often suffer from neural hypersensitization. These patients have often exhausted numerous treatments and still suffer from intractable pruritus. As chronic pain and chronic pruritus share many similarities, the use of medical treatments that reduce neural sensitization in intractable chronic pain may similarly help intractable chronic itch. One of the fastest growing treatments for chronic pain management is spinal neuromodulation. To our knowledge, the use of these modalities has not been applied to chronic intractable itch. The dorsal root ganglion (DRG) has recently become a target for neuromodulation. Through this review, we evaluate the rationale behind the use of the DRG electrical stimulation modality for chronic pain and assess its potential utility for patients with chronic, intractable pruritus. Given the similarities between chronic pain and chronic pruritus and the success of DRG neurostimulation in chronic pain, it may prove worthwhile to explore the efficacy of the modality for specific conditions presenting with chronic intractable pruritus.