The Impact of Activity-Based Interventions on Neuropathic Pain in Experimental Spinal Cord Injury

Cells, 2022 · DOI: 10.3390/cells11193087 · Published: September 30, 2022

Spinal Cord Injury Pain Management Rehabilitation

Simple Explanation

Physical activity-based rehabilitative interventions are a primary treatment for spinal cord injury (SCI). These interventions may also relieve neuropathic pain (NP) states, potentially by modulating inflammation and inducing functional and structural changes in the spinal cord. Animal models, including treadmill training, wheel running, and swimming, have demonstrated benefits, but the exact cellular and molecular mechanisms are not fully understood. More research is needed to develop individualized rehabilitative therapies for SCI patients with NP. This review examines preclinical studies, mechanisms of SCI-NP in relation to activity-based interventions (ABI), and the effectiveness of different activity-based paradigms, offering suggestions for future research.

Study Duration

Not specified

Participants

Preclinical rodent models

Evidence Level

Review

Key Findings

1
Weight-bearing rhythmic activity-based paradigms seem effective for neuropathic pain relief after spinal cord injury, regardless of whether interventions are started early or delayed, or applied for short or long durations, but the benefits may not persist long after halting the interventions.
2
Multiple activity-based paradigms alleviate neuropathic pain through mechanisms such as reducing inflammatory signaling, restoring local inhibitory mechanisms of dorsal horn neurons, and modulating maladaptive plasticity in the spinal cord gray matter circuitry.
3
The reproducibility of mechanistic findings requires further investigation due to the limited number of studies. Independent validation of single findings is strongly recommended.

Research Summary

This review examines the potential of activity-based interventions (ABI) to alleviate neuropathic pain (NP) following spinal cord injury (SCI) in preclinical rodent models. It focuses on molecular and cellular mechanisms. The review categorizes activity-based intervention methods and identifies key elements in successful interventions for SCI-NP alleviation, highlighting the mechanisms by which ABI modulates SCI-NP. The authors also suggest improving preclinical research by incorporating more emotional components of NP-related assessments, exploring the characteristics of SCI-NP, and examining the effects of ABI in both sexes and various experimental models for better clinical translation.

Practical Implications

Individualized Therapy Development

Findings provide essential analgesic elements of ABI to consider when developing individualized therapeutic methods in the clinic.

Intervention Timing

The timing of intervention (early or delayed) can be determined based on patients’ injury severity and functional recovery.

ABI Modality Selection

Continuous and regular weight-bearing rhythmic ABI (e.g., treadmill training, task-oriented walking) can be employed depending on the recovery extent.

Study Limitations

1
Reproducibility of mechanistic findings requires further consideration due to temporary scarcity of studies on this particular scope
2
There are currently relatively few independent studies that directly compare various ABI modalities. The conclusions presented here are based on comparisons from various investigations
3
Insufficient housing conditions can lead to the development of stress and depression in laboratory animals, which may exacerbate SCI-NP symptoms

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