Intramuscular Pulsed Radiofrequency Upregulates BNDF-TrKB Expression in the Spinal Cord in Rats as an Alternative Treatment for Complicated Pain

Int. J. Mol. Sci., 2024 · DOI: 10.3390/ijms25137199 · Published: June 29, 2024

Simple Explanation

This study explores a new way to treat complicated pain, like that experienced after spinal fusion surgery or with myofascial pain syndrome, by using intramuscular pulsed radiofrequency (PRF). PRF involves applying short bursts of radiofrequency to muscles, which may help reduce pain. The research found that PRF can increase the levels of a protein called brain-derived neurotrophic factor (BDNF) in the spinal cord. BDNF is important for nerve development and pain control. By increasing BDNF levels, PRF may help modulate pain signals. The study suggests that PRF applied to muscles could be an alternative treatment for complicated pain, especially when other treatments are not suitable. The optimal temperature for PRF was found to be 42 ◦C.

Study Duration

7 and 14 days

Participants

30 adult male Sprague–Dawley rats

Evidence Level

Animal study

Key Findings

1
PRF upregulates brain-derived neurotrophic factor (BDNF) in the spinal cord in both groups of rats.
2
Significant BDNF and tropomyosin receptor kinase B (TrkB) expression within the spinal cord after PRF in muscles and nerves after nerve injury.
3
PRF on the muscle could provide a similar effect in pain reduction as PRF for nerve injuries and the associated factor was BNDF.

Research Summary

The study investigated the effects of intramuscular pulsed radiofrequency (PRF) on complicated pain using a two-stage animal study. The first stage examined the effects of PRF on muscle and sciatic nerve at different temperatures, while the second stage evaluated PRF on muscle and nerve injury. Results showed that PRF upregulated brain-derived neurotrophic factor (BDNF) in the spinal cord, and significant BDNF and tropomyosin receptor kinase B (TrkB) expression was observed after PRF in muscles and nerves after nerve injury. Blood biomarkers also showed a significant increase in BDNF levels. The study concludes that PRF in the muscle in rats could upregulate BDNF-TrkB in the spinal cord, similar to PRF on the sciatica nerve for pain relief in rats. PRF could be considered clinically for patients with complicated pain, with 42 ◦C identified as the optimal temperature.

Practical Implications

Alternative Treatment Option

Intramuscular PRF may serve as an alternative treatment for patients with complicated pain, such as those with posterior spinal instrumentation or myofascial pain, especially when traditional methods are not feasible.

Pain Modulation Mechanism

The study demonstrates the role of BDNF in pain modulation, suggesting that PRF's pain-relieving effects are mediated by the upregulation of BDNF and TrkB in the spinal cord.

Clinical Consideration

Clinicians may consider PRF for patients with facet joint pain and myofascial pain, particularly in cases where posterior spinal instrumentation is present. The optimal temperature for PRF application is 42 ◦C.

Study Limitations

1
The absence of an adequate animal model for complicated pain
2
Current animal models cannot provide the exact mechanism for such rapid pain relief because many mechanisms are involved
3
The study was conducted on rats, and the results may not be directly applicable to humans.

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