The impact of electrical charge delivery on inhibition of mechanical hypersensitivity in nerve-injured rats by sub-sensory threshold spinal cord stimulation

Neuromodulation, 2019 · DOI: 10.1111/ner.12910 · Published: February 1, 2019

Simple Explanation

This study explores how spinal cord stimulation (SCS) at different frequencies, but below the level where the rats can feel it (sub-sensory threshold), can reduce pain in rats with nerve damage. The researchers tested different SCS patterns and looked at how the amount of electrical charge delivered affected pain relief. They found that low-frequency SCS could be effective if the electrical charge delivery is optimized, potentially offering a more energy-efficient approach to pain management.

Study Duration

Not specified

Participants

32 nerve-injured Sprague-Dawley rats

Evidence Level

Level III, Animal Study

Key Findings

1
Both high (10 kHz) and lower frequencies (200 Hz, 500 Hz, 1200 Hz) of subthreshold SCS attenuated mechanical hypersensitivity in nerve-injured rats.
2
Pain inhibition from different patterns of subthreshold SCS was not governed by individual stimulation parameters alone.
3
Pain inhibition from 10 kHz subthreshold SCS in individual animals was positively correlated with the electric charges delivered per second.

Research Summary

The study aimed to determine whether sub-sensory threshold SCS of lower frequencies can also inhibit mechanical hypersensitivity in nerve-injured rats and examine how electric charge delivery of stimulation may affect pain inhibition by different patterns of subthreshold SCS. Both 10,000 Hz and lower frequencies of subthreshold SCS attenuated mechanical hypersensitivity, as indicated by increased PWTs after stimulation in SNL rats. Inhibition of neuropathic mechanical hypersensitivity can be achieved with low-frequency subthreshold SCS by optimizing the electric charge delivery, which may affect the effect of SCS in individual animals.

Practical Implications

Clinical Application

Low-frequency subthreshold SCS could be a more energy-efficient stimulation paradigm for pain management compared to high-frequency stimulation.

Personalized Treatment

Optimizing electrical charge delivery may enhance the efficacy of subthreshold SCS in individual patients.

Future Research

Further exploration of optimal waveforms and mechanisms of subthreshold SCS is warranted to improve clinical efficacy and expand indications.

Study Limitations

1
The study focused solely on mechanical hypersensitivity in rats, which may not fully represent other aspects of neuropathic pain in humans.
2
The precise mechanisms of pain relief by subthreshold high-frequency SCS remain unclear.
3
The correlation between pain inhibition and electrical dose does not establish a cause-and-effect relationship.

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