High Frequency Impulse Therapy for Neuropathic Pain in NMOSD

Prior treatment

• Any of the following: pregnant women, nursing women, women of childbearing potential or their sexual partners who are unwilling to employ adequate contraception (condoms, diaphragm, birth control pills, injections, intrauterine device \[IUD\], surgical sterilization, subcutaneous implants, abstinence, etc.).
• Use of an investigational agent for pain control concurrently or within the past 30 days
• History of an allergic reaction or previous intolerance to transcutaneous electronic nerve stimulation or to latex
• Patients with implantable drug delivery systems, e.g. Medtronic Synchromed.
• Prior celiac plexus block, or other neurolytic pain control treatment, within 1 month
• Other identified causes of painful parasthesias existing prior to chemotherapy (e.g., carpal tunnel syndrome, B12 deficiency, AIDS, monoclonal gammopathy, diabetes, heavy metal poisoning amyloidosis, syphilis, hyperthyroidism or hypothyroidism, inherited neuropathy, etc.) that might be responsible for the patient's current neuropathic symptoms
• Patients with an ongoing concomitant central neurologic disorder or history of epilepsy, brain damage, or symptomatic brain metastases

Other illness

• Patients with heart stents or metal implants such as pacemakers, automatic defibrillators, cochlear implants, aneurysm clips, vena cava clips and skull plates (Metal implants for orthopedic repair, e.g. pins, clips, plates, cages, joint replacements are allowed)
• Patients with a known history of myocardial infarction or ischemic heart disease within the past six months
• Skin conditions such as open sores that would prevent proper application of the electrodes
• Other medical or other condition(s) that in the opinion of the investigators might compromise the objectives of the study

Other

• Patients who are cognitively or mentally incompetent

• Men and women 18 years of age or older diagnosed with NMOSD per the 2015 NMOSD criteria
• Patients must be positive for the aquaporin-4 antibody in serum.
• Presence of persistent neuropathic pain (\>3 months) rated at a level of 4 or higher on the Wong-Baker Faces Pain Scale
• Patients must be stable in their disease, such that they have had no spinal cord relapses within 6 months prior to enrollment
• Patients must be on a stable medication regimen that may include anti-epileptic, antidepressant, or non-steroidal anti-inflammatory medications, with no adjustments to the regimen within 30 days of enrollment
• Pain must be localized to a spinal cord lesion
• Patient understands the study regimen, its requirements, risks, and discomforts, and is able and willing to sign an informed consent form