Burst and Tonic Spinal Cord Stimulation in the Mechanical Conﬂict-Avoidance System: Cognitive-Motivational Aspects

Neuromodulation, 2020 · DOI: 10.1111/ner.12955 · Published: July 1, 2020

Simple Explanation

The study investigates how different types of spinal cord stimulation (SCS), namely Burst-SCS and Tonic-SCS, affect the cognitive and motivational aspects of pain relief in rats with neuropathic pain. The researchers used a mechanical conﬂict-avoidance system (MCAS) where rats had to choose between a bright, unpleasant area and crossing a field of painful probes to reach a dark, preferred area. The study found that Burst-SCS had a more significant impact on the rats' behavior in the MCAS compared to Tonic-SCS, suggesting it more effectively targets the cognitive-motivational aspects of pain.

Study Duration

Not specified

Participants

38 male Sprague Dawley rats in experiment 1 and 12 in experiment 2

Evidence Level

Level 3; Animal study

Key Findings

1
MCAS exit latencies differed significantly between Burst SCS and Tonic SCS at 4 mm and 5 mm probe heights, indicating differential effects on cognitive-motivational aspects of pain.
2
Von Frey testing did not detect significant differences between Tonic-SCS and Burst-SCS, suggesting that MCAS is more sensitive to cognitive-motivational aspects of pain relief.
3
The partial sciatic nerve ligation (PSNL) rat model increased exit latency in the MCAS, validating it as an operant testing method for assessing affective-motivational aspects of pain.

Research Summary

This study aimed to assess the cognitive-motivational aspects of Tonic- and Burst SCS-induced pain relief in rats with chronic neuropathic pain using the mechanical conﬂict-avoidance system (MCAS). The results showed that Burst SCS exit latencies differed signiﬁcantly from Tonic SCS exit latencies at 4 mm and 5 mm probe height, but this difference was not detected with reﬂex-based Von Frey testing. The findings suggest that Burst-SCS specifically affects the processing of cognitive-motivational aspects of pain more than Tonic-SCS, and that MCAS exit latency testing allows for the detection of these effects.

Practical Implications

Enhanced Pain Management Strategies

The study suggests Burst-SCS may be a more effective approach for managing the cognitive and motivational aspects of chronic pain.

Improved Preclinical Assessment

The MCAS operant testing method can be used to better assess the cognitive-motivational components of pain relief in preclinical studies.

Targeted Neuromodulation Therapies

The research supports the development of targeted neuromodulation therapies that specifically address the supraspinal mechanisms of pain.

Study Limitations

1
Only male rats were used, potentially limiting the generalizability of the findings to females.
2
The incremental presentation of probe heights may have introduced a learning curve for the animals.
3
The study did not explore the long-term effects of SCS on cognitive-motivational aspects of pain.

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