Conventional and kilohertz-frequency spinal cord stimulation produces intensity- and frequency-dependent inhibition of mechanical hypersensitivity in a rat model of neuropathic pain
Ronen Shechter, Fei Yang, Qian Xu, Yong-Kwan Cheong, Shao-Qiu He, Andrei Sdrulla, Alene F Carteret, Paul W Wacnik, Xinzhong Dong, Richard A Meyer, Srinivasa N Raja, Yun Guan, Ronen Shechter, Fei Yang, Qian Xu, Yong-Kwan Cheong, Shao-Qiu He, Andrei Sdrulla, Alene F Carteret, Paul W Wacnik, Xinzhong Dong, Richard A Meyer, Srinivasa N Raja, Yun Guan
Abstract
Background: Spinal cord stimulation (SCS) is a useful neuromodulatory technique for treatment of certain neuropathic pain conditions. However, the optimal stimulation parameters remain unclear.
Methods: In rats after L5 spinal nerve ligation, the authors compared the inhibitory effects on mechanical hypersensitivity from bipolar SCS of different intensities (20, 40, and 80% motor threshold) and frequencies (50, 1 kHz, and 10 kHz). The authors then compared the effects of 1 and 50 Hz dorsal column stimulation at high- and low-stimulus intensities on conduction properties of afferent Aα/β-fibers and spinal wide-dynamic-range neuronal excitability.
Results: Three consecutive daily SCS at different frequencies progressively inhibited mechanical hypersensitivity in an intensity-dependent manner. At 80% motor threshold, the ipsilateral paw withdrawal threshold (% preinjury) increased significantly from pre-SCS measures, beginning with the first day of SCS at the frequencies of 1 kHz (50.2 ± 5.7% from 23.9 ± 2.6%, n = 19, mean ± SEM) and 10 kHz (50.8 ± 4.4% from 27.9 ± 2.3%, n = 17), whereas it was significantly increased beginning on the second day in the 50 Hz group (38.9 ± 4.6% from 23.8 ± 2.1%, n = 17). At high intensity, both 1 and 50 Hz dorsal column stimulation reduced Aα/β-compound action potential size recorded at the sciatic nerve, but only 1 kHz stimulation was partially effective at the lower intensity. The number of actions potentials in C-fiber component of wide-dynamic-range neuronal response to windup-inducing stimulation was significantly decreased after 50 Hz (147.4 ± 23.6 from 228.1 ± 39.0, n = 13), but not 1 kHz (n = 15), dorsal column stimulation.
Conclusions: Kilohertz SCS attenuated mechanical hypersensitivity in a time course and amplitude that differed from conventional 50 Hz SCS, and may involve different peripheral and spinal segmental mechanisms.
Conflict of interest statement
Conflicts of Interest: Drs. Srinivasa N. Raja and Yun Guan have received research grant support from Medtronic, Inc. Paul W. Wacnik is employed by Medtronic, Inc (Minneapolis, Minnesota). However, none of the authors has a commercial interest in the material presented in this paper. No other relationships might lead to a conflict of interest in the current study.
Figures
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Dorsal column conditioning stimulation of…
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Dorsal column conditioning stimulation of 50 Hz, but not of 1 kHz, inhibited…
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- Animals
- Disease Models, Animal
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- Neuralgia / therapy*
- Pain Measurement / methods
- Pain Threshold
- Rats
- Rats, Sprague-Dawley
- Spinal Cord / physiopathology*
- Spinal Cord Stimulation / methods*
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Source: PubMed