Effect of epidural spinal cord stimulation on female sexual function after spinal cord injury

Claire Shackleton, Soshi Samejima, Tiev Miller, Rahul Sachdeva, Ann Parr, Uzma Samadani, Theoden Netoff, Shea Hocaloski, Stacy Elliott, Matthias Walter, David Darrow, Andrei Krassioukov

Research output: Contribution to journalArticlepeer-review

Abstract

Sexual dysfunction is a common consequence for women with spinal cord injury (SCI); however, current treatments are ineffective, especially in the under-prioritized population of women with SCI. This case-series, a secondary analysis of the Epidural Stimulation After Neurologic Damage (E-STAND) clinical trial aimed to investigate the effect of epidural spinal cord stimulation (ESCS) on sexual function and distress in women with SCI. Three females, with chronic, thoracic, sensorimotor complete SCI received daily (24 h/day) tonic ESCS for 13 months. Questionnaires, including the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale (FSDS) were collected monthly. There was a 3.2-point (13.2%) mean increase in total FSFI from baseline (24.5 ± 4.1) to post-intervention (27.8 ± 6.6), with a 4.8–50% improvement in the sub-domains of desire, arousal, orgasm and satisfaction. Sexual distress was reduced by 55%, with a mean decrease of 12 points (55.4%) from baseline (21.7 ± 17.2) to post-intervention (9.7 ± 10.8). There was a clinically meaningful change of 14 points in the International Standards for Neurological Classification of Spinal Cord Injury total sensory score from baseline (102 ± 10.5) to post-intervention (116 ± 17.4), without aggravating dyspareunia. ESCS is a promising treatment for sexual dysfunction and distress in women with severe SCI. Developing therapeutic interventions for sexual function is one of the most meaningful recovery targets for people with SCI. Additional large-scale investigations are needed to understand the long-term safety and feasibility of ESCS as a viable therapy for sexual dysfunction. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03026816, NCT03026816.

Original languageEnglish (US)
Article number1155796
JournalFrontiers in Neuroscience
Volume17
DOIs
StatePublished - 2023

Bibliographical note

Funding Information:
This work was supported by the Minnesota Office of Higher Education, and the University of Minnesota MNDrive. Krassioukov holds Endowed Chair in rehabilitation medicine, University of British Columbia, and his laboratory is supported by funds from the Canadian Institute for Health Research (#PJT-156033), Canadian Foundation for Innovation and BC Knowledge Development Fund (#35869), and PRAXIS Spinal Cord Institute. Dr. Shackleton is supported by a Paralyzed Veterans of America Fellowship (#3189) and the Rick Hansen Foundation (#2007-21). Dr. Samejima is supported by a Paralyzed Veterans of America Fellowship (#3190), Wings for Life Spinal Cord Research Foundation (#2020_097), and the Rick Hansen Foundation (#2007-21). Dr. Miller is supported by the Michael Smith Foundation for Health Research and the Rick Hansen Foundation (#2007-21). Dr. Walter was supported by the Michael Smith Foundation for Health Research and the Rick Hansen Foundation (#17110). Dr. Sachdeva is supported by Wings for Life Spinal Cord Research Foundation (#WFL-CA-20/21).

Publisher Copyright:
Copyright © 2023 Shackleton, Samejima, Miller, Sachdeva, Parr, Samadani, Netoff, Hocaloski, Elliott, Walter, Darrow and Krassioukov.

Keywords

  • neuromodulation
  • orgasm
  • sexual arousal
  • sexual dysfunction
  • sexual health
  • sexuality
  • spinal cord injuries

PubMed: MeSH publication types

  • Journal Article

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