Conventional and kilohertz-frequency spinal cord stimulation produces intensity-and frequency-dependent inhibition of mechanical hypersensitivity in a rat model of neuropathic pain

Ronen Shechter, Fei Yang, Qian Xu, Yong Kwan Cheong, Shao Qiu He, Andrei Sdrulla, Alene F. Carteret, Paul W. Wacnik, Xinzhong Dong, Richard A. Meyer, Srinivasa N. Raja, Yun Guan

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

BACKGROUND: Spinal cord stimulation (SCS) is a useful neuromodulatory technique for treatment of certain neuropathic pain conditions. However, the optimal stimulation parameters remain unclear. METHODS: In rats after L5 spinal nerve ligation, the authors compared the inhibitory effects on mechanical hypersensitivity from bipolar SCS of different intensities (20, 40, and 80% motor threshold) and frequencies (50, 1 kHz, and 10 kHz). The authors then compared the effects of 1 and 50 Hz dorsal column stimulation at high-and low-stimulus intensities on conduction properties of afferent Aα/β-fibers and spinal wide-dynamic-range neuronal excitability. RESULTS: Three consecutive daily SCS at different frequencies progressively inhibited mechanical hypersensitivity in an intensity-dependent manner. At 80% motor threshold, the ipsilateral paw withdrawal threshold (% preinjury) increased significantly from pre-SCS measures, beginning with the first day of SCS at the frequencies of 1 kHz (50.2 ± 5.7% from 23.9 ± 2.6%, n = 19, mean ± SEM) and 10 kHz (50.8 ± 4.4% from 27.9 ± 2.3%, n = 17), whereas it was significantly increased beginning on the second day in the 50 Hz group (38.9 ± 4.6% from 23.8 ± 2.1%, n = 17). At high intensity, both 1 and 50 Hz dorsal column stimulation reduced Aα/β-compound action potential size recorded at the sciatic nerve, but only 1 kHz stimulation was partially effective at the lower intensity. The number of actions potentials in C-fiber component of wide-dynamic-range neuronal response to windup-inducing stimulation was significantly decreased after 50 Hz (147.4 ± 23.6 from 228.1 ± 39.0, n = 13), but not 1 kHz (n = 15), dorsal column stimulation. CONCLUSIONS: Kilohertz SCS attenuated mechanical hypersensitivity in a time course and amplitude that differed from conventional 50 Hz SCS, and may involve different peripheral and spinal segmental mechanisms.

Original languageEnglish (US)
Pages (from-to)422-432
Number of pages11
JournalAnesthesiology
Volume119
Issue number2
DOIs
StatePublished - Aug 2013
Externally publishedYes

Fingerprint

Spinal Cord Stimulation
Neuralgia
Hypersensitivity
Action Potentials
Myelinated Nerve Fibers
Spinal Nerves
Unmyelinated Nerve Fibers
Sciatic Nerve
Ligation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Conventional and kilohertz-frequency spinal cord stimulation produces intensity-and frequency-dependent inhibition of mechanical hypersensitivity in a rat model of neuropathic pain. / Shechter, Ronen; Yang, Fei; Xu, Qian; Cheong, Yong Kwan; He, Shao Qiu; Sdrulla, Andrei; Carteret, Alene F.; Wacnik, Paul W.; Dong, Xinzhong; Meyer, Richard A.; Raja, Srinivasa N.; Guan, Yun.

In: Anesthesiology, Vol. 119, No. 2, 08.2013, p. 422-432.

Research output: Contribution to journalArticle

Shechter, Ronen ; Yang, Fei ; Xu, Qian ; Cheong, Yong Kwan ; He, Shao Qiu ; Sdrulla, Andrei ; Carteret, Alene F. ; Wacnik, Paul W. ; Dong, Xinzhong ; Meyer, Richard A. ; Raja, Srinivasa N. ; Guan, Yun. / Conventional and kilohertz-frequency spinal cord stimulation produces intensity-and frequency-dependent inhibition of mechanical hypersensitivity in a rat model of neuropathic pain. In: Anesthesiology. 2013 ; Vol. 119, No. 2. pp. 422-432.
@article{507cb58e360449cb89d4c93d019148ee,
title = "Conventional and kilohertz-frequency spinal cord stimulation produces intensity-and frequency-dependent inhibition of mechanical hypersensitivity in a rat model of neuropathic pain",
abstract = "BACKGROUND: Spinal cord stimulation (SCS) is a useful neuromodulatory technique for treatment of certain neuropathic pain conditions. However, the optimal stimulation parameters remain unclear. METHODS: In rats after L5 spinal nerve ligation, the authors compared the inhibitory effects on mechanical hypersensitivity from bipolar SCS of different intensities (20, 40, and 80{\%} motor threshold) and frequencies (50, 1 kHz, and 10 kHz). The authors then compared the effects of 1 and 50 Hz dorsal column stimulation at high-and low-stimulus intensities on conduction properties of afferent Aα/β-fibers and spinal wide-dynamic-range neuronal excitability. RESULTS: Three consecutive daily SCS at different frequencies progressively inhibited mechanical hypersensitivity in an intensity-dependent manner. At 80{\%} motor threshold, the ipsilateral paw withdrawal threshold ({\%} preinjury) increased significantly from pre-SCS measures, beginning with the first day of SCS at the frequencies of 1 kHz (50.2 ± 5.7{\%} from 23.9 ± 2.6{\%}, n = 19, mean ± SEM) and 10 kHz (50.8 ± 4.4{\%} from 27.9 ± 2.3{\%}, n = 17), whereas it was significantly increased beginning on the second day in the 50 Hz group (38.9 ± 4.6{\%} from 23.8 ± 2.1{\%}, n = 17). At high intensity, both 1 and 50 Hz dorsal column stimulation reduced Aα/β-compound action potential size recorded at the sciatic nerve, but only 1 kHz stimulation was partially effective at the lower intensity. The number of actions potentials in C-fiber component of wide-dynamic-range neuronal response to windup-inducing stimulation was significantly decreased after 50 Hz (147.4 ± 23.6 from 228.1 ± 39.0, n = 13), but not 1 kHz (n = 15), dorsal column stimulation. CONCLUSIONS: Kilohertz SCS attenuated mechanical hypersensitivity in a time course and amplitude that differed from conventional 50 Hz SCS, and may involve different peripheral and spinal segmental mechanisms.",
author = "Ronen Shechter and Fei Yang and Qian Xu and Cheong, {Yong Kwan} and He, {Shao Qiu} and Andrei Sdrulla and Carteret, {Alene F.} and Wacnik, {Paul W.} and Xinzhong Dong and Meyer, {Richard A.} and Raja, {Srinivasa N.} and Yun Guan",
year = "2013",
month = "8",
doi = "10.1097/ALN.0b013e31829bd9e2",
language = "English (US)",
volume = "119",
pages = "422--432",
journal = "Anesthesiology",
issn = "0003-3022",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Conventional and kilohertz-frequency spinal cord stimulation produces intensity-and frequency-dependent inhibition of mechanical hypersensitivity in a rat model of neuropathic pain

AU - Shechter, Ronen

AU - Yang, Fei

AU - Xu, Qian

AU - Cheong, Yong Kwan

AU - He, Shao Qiu

AU - Sdrulla, Andrei

AU - Carteret, Alene F.

AU - Wacnik, Paul W.

AU - Dong, Xinzhong

AU - Meyer, Richard A.

AU - Raja, Srinivasa N.

AU - Guan, Yun

PY - 2013/8

Y1 - 2013/8

N2 - BACKGROUND: Spinal cord stimulation (SCS) is a useful neuromodulatory technique for treatment of certain neuropathic pain conditions. However, the optimal stimulation parameters remain unclear. METHODS: In rats after L5 spinal nerve ligation, the authors compared the inhibitory effects on mechanical hypersensitivity from bipolar SCS of different intensities (20, 40, and 80% motor threshold) and frequencies (50, 1 kHz, and 10 kHz). The authors then compared the effects of 1 and 50 Hz dorsal column stimulation at high-and low-stimulus intensities on conduction properties of afferent Aα/β-fibers and spinal wide-dynamic-range neuronal excitability. RESULTS: Three consecutive daily SCS at different frequencies progressively inhibited mechanical hypersensitivity in an intensity-dependent manner. At 80% motor threshold, the ipsilateral paw withdrawal threshold (% preinjury) increased significantly from pre-SCS measures, beginning with the first day of SCS at the frequencies of 1 kHz (50.2 ± 5.7% from 23.9 ± 2.6%, n = 19, mean ± SEM) and 10 kHz (50.8 ± 4.4% from 27.9 ± 2.3%, n = 17), whereas it was significantly increased beginning on the second day in the 50 Hz group (38.9 ± 4.6% from 23.8 ± 2.1%, n = 17). At high intensity, both 1 and 50 Hz dorsal column stimulation reduced Aα/β-compound action potential size recorded at the sciatic nerve, but only 1 kHz stimulation was partially effective at the lower intensity. The number of actions potentials in C-fiber component of wide-dynamic-range neuronal response to windup-inducing stimulation was significantly decreased after 50 Hz (147.4 ± 23.6 from 228.1 ± 39.0, n = 13), but not 1 kHz (n = 15), dorsal column stimulation. CONCLUSIONS: Kilohertz SCS attenuated mechanical hypersensitivity in a time course and amplitude that differed from conventional 50 Hz SCS, and may involve different peripheral and spinal segmental mechanisms.

AB - BACKGROUND: Spinal cord stimulation (SCS) is a useful neuromodulatory technique for treatment of certain neuropathic pain conditions. However, the optimal stimulation parameters remain unclear. METHODS: In rats after L5 spinal nerve ligation, the authors compared the inhibitory effects on mechanical hypersensitivity from bipolar SCS of different intensities (20, 40, and 80% motor threshold) and frequencies (50, 1 kHz, and 10 kHz). The authors then compared the effects of 1 and 50 Hz dorsal column stimulation at high-and low-stimulus intensities on conduction properties of afferent Aα/β-fibers and spinal wide-dynamic-range neuronal excitability. RESULTS: Three consecutive daily SCS at different frequencies progressively inhibited mechanical hypersensitivity in an intensity-dependent manner. At 80% motor threshold, the ipsilateral paw withdrawal threshold (% preinjury) increased significantly from pre-SCS measures, beginning with the first day of SCS at the frequencies of 1 kHz (50.2 ± 5.7% from 23.9 ± 2.6%, n = 19, mean ± SEM) and 10 kHz (50.8 ± 4.4% from 27.9 ± 2.3%, n = 17), whereas it was significantly increased beginning on the second day in the 50 Hz group (38.9 ± 4.6% from 23.8 ± 2.1%, n = 17). At high intensity, both 1 and 50 Hz dorsal column stimulation reduced Aα/β-compound action potential size recorded at the sciatic nerve, but only 1 kHz stimulation was partially effective at the lower intensity. The number of actions potentials in C-fiber component of wide-dynamic-range neuronal response to windup-inducing stimulation was significantly decreased after 50 Hz (147.4 ± 23.6 from 228.1 ± 39.0, n = 13), but not 1 kHz (n = 15), dorsal column stimulation. CONCLUSIONS: Kilohertz SCS attenuated mechanical hypersensitivity in a time course and amplitude that differed from conventional 50 Hz SCS, and may involve different peripheral and spinal segmental mechanisms.

UR - http://www.scopus.com/inward/record.url?scp=84880913835&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880913835&partnerID=8YFLogxK

U2 - 10.1097/ALN.0b013e31829bd9e2

DO - 10.1097/ALN.0b013e31829bd9e2

M3 - Article

VL - 119

SP - 422

EP - 432

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 2

ER -