Burst and Tonic Spinal Cord Stimulation Both Activate Spinal GABAergic Mechanisms to Attenuate Pain in a Rat Model of Chronic Neuropathic Pain

Pain Practice, 2020 · DOI: 10.1111/papr.12831 · Published: January 1, 2020

Simple Explanation

This study investigates how two types of spinal cord stimulation (SCS), tonic and burst, affect pain relief in rats with nerve damage. Researchers focused on the role of a neurotransmitter called GABA, which is known to inhibit pain signals in the spinal cord. The study found that both tonic and burst SCS reduce pain by activating GABA-related mechanisms in the spinal cord. This suggests that both types of SCS rely on GABA to alleviate neuropathic pain. These findings support the idea that enhancing GABA's activity in the spinal cord can be a key factor in managing chronic neuropathic pain, regardless of the type of spinal cord stimulation used.

Study Duration

Not specified

Participants

36 male Sprague Dawley rats

Evidence Level

Not specified

Key Findings

1
Burst SCS significantly lowers intracellular GABA levels in the spinal dorsal horn compared to sham SCS and tonic SCS.
2
Blocking GABAA and GABAB receptors with antagonists eliminates the pain-relieving effects of both tonic and burst SCS.
3
The analgesic effect of burst SCS is mediated via a spinal GABAergic mechanism.

Research Summary

This study investigates the role of GABAergic mechanisms in the analgesic effects of burst and tonic spinal cord stimulation (SCS) in a rat model of chronic neuropathic pain induced by partial sciatic nerve ligation (PSNL). The study found that burst SCS significantly decreased intracellular GABA levels in the spinal dorsal horn compared to sham and tonic SCS. Furthermore, the administration of GABAA and GABAB receptor antagonists abolished the analgesic effects of both burst and tonic SCS. The authors conclude that the analgesic effect of burst SCS, similar to tonic SCS, is mediated via spinal GABAergic mechanisms in this animal model of neuropathic pain.

Practical Implications

Understanding SCS Mechanisms

Provides insights into the mechanisms underlying both burst and tonic SCS, specifically highlighting the involvement of GABAergic pathways.

Refining SCS Therapies

Suggests potential targets for refining SCS therapies by focusing on enhancing GABAergic activity in the spinal cord.

Personalized Pain Management

Understanding the specific mechanisms could lead to more personalized pain management strategies by selecting the most effective SCS paradigm for individual patients.

Study Limitations

1
The study was conducted on a rat model of neuropathic pain, which may not fully translate to human conditions.
2
The study focused on a specific type of neuropathic pain model (PSNL), limiting the generalizability to other types of neuropathic pain.
3
Further analysis of the GABAergic mechanisms underlying burst SCS at different time points could shed more light on the exact mechanisms at play.

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