High‑voltage pulsed radiofrequency improves ultrastructure of DRG and enhances spinal microglial autophagy to ameliorate neuropathic pain induced by SNI

Scientific Reports, 2024 · DOI: 10.1038/s41598-024-55095-5 · Published: February 20, 2024

Simple Explanation

This study investigates the effectiveness of high-voltage pulsed radiofrequency (HVPRF) in treating neuropathic pain (NeP) in rats with spared nerve injury (SNI). Different voltages of PRF were applied to the dorsal root ganglion (DRG) to determine the optimal therapeutic voltage. The study found that 85V-PRF was superior to other PRF treatments in alleviating NeP, improving DRG ultrastructure, and promoting autophagy in spinal microglia. The underlying mechanisms may involve repairing DRG damage and regulating spinal microglial autophagy. The researchers analyzed changes in DRG ultrastructure, ATF3 expression, autophagy in microglia, and levels of TNF-α and IL-10 in the spinal cord to understand the mechanisms behind HVPRF-induced NeP relief.

Study Duration

21 days

Participants

280 male Sprague‒Dawley rats

Evidence Level

Not specified

Key Findings

1
HVPRF application on the DRG significantly reduced mechanical allodynia, cold allodynia, and spontaneous pain induced by SNI in rats, with 85VPRF showing the best therapeutic efficacy.
2
PRF treatment modulated the autophagy process and expression of inflammatory cytokines. HVPRF, especially 85VPRF, was more effective in enhancing microglial autophagy and increasing IL-10 levels in the spinal cord.
3
Different voltages of PRF could reduce DRG injury induced by SNI, promote repair of damaged nerve fibers, and modulate the inflammatory response, with 85VPRF showing the best improvement.

Research Summary

This study explores the optimal voltage for high-voltage pulsed radiofrequency (HVPRF) to treat neuropathic pain (NeP) in spared nerve injury (SNI) rats, focusing on pain reduction and underlying mechanisms. The results indicate that 85V PRF is the most effective voltage, improving DRG ultrastructure, enhancing microglial autophagy, and regulating inflammatory cytokines (TNF-α and IL-10) in the spinal cord. The study provides insights into the analgesic mechanisms of HVPRF, suggesting its potential clinical application in NeP treatment by repairing nerve damage and modulating neuroinflammation.

Practical Implications

Optimal Voltage Identification

The study identifies 85V as the optimal voltage for HVPRF treatment of neuropathic pain in rats, which could inform clinical protocols.

Mechanism Elucidation

The research elucidates the mechanisms of HVPRF, linking it to DRG repair, microglial autophagy modulation, and regulation of inflammatory cytokines, providing a rationale for its efficacy.

Clinical Translation Potential

The findings support the clinical application of HVPRF for neuropathic pain treatment, suggesting that HVPRF, particularly at 85V, may offer improved pain relief and nerve repair compared to standard voltage PRF.

Study Limitations

1
The therapeutic effect of HVPRF was only tested on the 14th and 21st days after SNI, and the overall trend of microglial autophagy levels in the SCDH was not observed, so the long-term efficacy of HVPRF needs further study.
2
Intra-SCDH injection of chloroquine, which is an autophagy inhibitor, or rapamycin was not performed to further confirm.
3
The conclusions of the study are based on the results of an animal model, and it is not known whether consistent results could be obtained in human studies.

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