Modulation of neuroglial interactions using differential target multiplexed spinal cord stimulation in an animal model of neuropathic pain

Molecular Pain, 2020 · DOI: 10.1177/1744806920918057 · Published: January 1, 2020

Simple Explanation

This study explores how different types of spinal cord stimulation (SCS) affect the interaction between nerve cells (neurons) and supporting cells (glia) in rats with nerve pain. The researchers compared a new SCS method called differential target multiplexed programming (DTMP) with traditional low and high-frequency SCS to see which one was best at reducing pain and changing gene activity in the spinal cord. The results showed that DTMP was more effective at reducing pain and normalizing gene expression related to pain pathways, suggesting it could be a better way to rebalance nerve and glial cell interactions.

Study Duration

48 hours SCS application

Participants

48 rats with spared nerve injury, 7 naive rats

Evidence Level

Animal model study

Key Findings

1
DTMP significantly reduced both mechanical and thermal hypersensitivity compared to low and high-rate SCS.
2
DTMP more effectively modulated genes associated with pain-related processes, returning their expression toward levels observed in naive, noninjured animals.
3
DTMP significantly modulated the expression patterns of 11 out of 23 modules (48%) in the direction of expression patterns shown by naïve animals.

Research Summary

This study investigated the effects of differential target multiplexed programming (DTMP) compared to low-rate (LR) and high-rate (HR) spinal cord stimulation (SCS) on neuropathic pain in rats. Behavioral results showed that DTMP was significantly more effective than LR and HR in reducing mechanical and thermal hypersensitivity. Transcriptomic analysis revealed that DTMP modulated a larger number of pain-related genes back towards their normal expression levels compared to LR and HR, suggesting a more effective rebalancing of neuroglial interactions.

Practical Implications

Improved Pain Management

DTMP may offer a more effective approach to managing neuropathic pain by better targeting and modulating neuroglial interactions.

Personalized SCS Therapy

Customizing SCS parameters to differentially target neurons and glial cells could optimize the therapeutic outcomes for individual patients.

Further Research

Future studies should investigate the long-term effects of DTMP and its potential benefits when applied earlier in the development of chronic pain.

Study Limitations

1
The study intervened at an early stage (5 days after injury), which may be considered largely an acute state transitioning into a chronic state.
2
SCS was also applied for a limited time (48 h), thus it is uncertain if the effects of HR and LR would have eventually leveraged the effects shown by DTMP.
3
Our study also did not evaluate if gene expression would return to the levels measured in untreated animals if the SCS system was turned off.

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