Attenuation of neuropathic pain by segmental and supraspinal activation of the dorsal column system in awake rats

El-Khoury, C; Hawwa, N; Baliki, Marwan N.; Atweh, Samir; Jabbur, Suhayl J.; Saadé, Nayef E.

doi:10.1016/s0306-4522(02)00111-2

Cited by 105 publications

(63 citation statements)

References 35 publications

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“…It should be noted that supraspinal sites are not required because electrical excitation of dorsal column in the present study and previous studies (Yakhnitsa et al, 1999;Foreman et al, 1976;Chandler et al, 1993;Myerson and Linderoth, 2003) and chemical activation C1-C2 neurons in other studies (Qin et al 1999;2004) still exert effects on activity of the spinal neurons with visceral inputs after cervicomedullary spinal transection. The results of SCS do not agree with studies showing that supraspinal pathways are required to activate the inhibitory (El-Khoury et al 2002;Rees and Roberts 1989;Saade et al 1985). Presently, this controversy has not been resolved.…”

Section: Modulatory Pathways and Mechanism Underlying Scsmentioning

confidence: 62%

“…In general, electric stimulation to the dorsal column, which contains large diameter afferent fibers, inhibits transmission of nociceptive information at the spinal segmental level. This finding implicates elements of the gate control theory (Melzack and Wall 1965), although activation of supraspinal circuits may also be involved (El-Khoury et al, 2002). Several experimental studies have been performed to explore effects of SCS on spinal neuronal processing of noxious somatic inputs.…”

Section: Introductionmentioning

confidence: 68%

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Spinal cord stimulation modulates intraspinal colorectal visceroreceptive transmission in rats

Qin

Lehew

Khan

et al. 2007

Neuroscience Research

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Previous studies have shown that spinal cord stimulation (SCS) of upper lumbar segments decreases visceromotor responses to mechanical stimuli in a sensitized rat colon and reduces symptoms of irritable bowel syndrome in patients. SCS applied to the upper cervical spinal dorsal column reduces pain of chronic refractory angina. Further, chemical stimulation of C1-C2 propriospinal neurons in rats modulates the responses of lumbosacral spinal neurons to colorectal distension. The present study was designed to compare the effects of upper cervical and lumbar SCS on activity of lumbosacral neurons receiving noxious colorectal input. Extracellular potentials of L6-S2 spinal neurons were recorded in pentobarbital anesthetized, paralyzed and ventilated male rats. SCS (50 Hz, 0.2 ms) at low intensity (90% of motor threshold) was applied to the dorsal column of upper cervical (C1-C2) or upper lumbar (L2-L3) ipsilateral spinal segments. Colorectal distension (CRD, 20, 40, 60 mmHg, 20 s) was produced by air inflation of a latex balloon. Results showed that SCS applied to L2-L3 and C1-C2 segments significantly reduced the excitatory responses to noxious CRD from 417.6±68.0 imp to 296.3±53.6 imp (P<0.05, n=24) and from 336.2±64.5 imp to 225.0±73.3 imp (P<0.05, n= 18), respectively. Effects of L2-L3 and C1-C2 SCS lasted 10.2±1.9 min and 8.0 ±0.9 min after offset of CRD. Effects of SCS were observed on spinal neurons with either high or low threshold excitatory responses to CRD. However, L2-L3 or C1-C2 SCS did not significantly affect inhibitory neuronal responses to CRD. C1-C2 SCS-induced effects were abolished by cutting the C7-C8 dorsal column but not by spinal transection at cervicomedullary junction. These data demonstrated that upper cervical or lumbar SCS modulated responses of lumbosacral spinal neurons to noxious mechanical stimulation of the colon, thereby, proved two loci for a potential therapeutic effect of SCS in patients with irritable bowel syndrome and other colonic disorders.

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Section: Modulatory Pathways and Mechanism Underlying Scsmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 68%

Spinal cord stimulation modulates intraspinal colorectal visceroreceptive transmission in rats

Qin

Lehew

Khan

et al. 2007

Neuroscience Research

View full text Add to dashboard Cite

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“…Also, the long interval before effect is seen contradicts this hypothesis. Some evidence also seems to indicate that supraspinal pain-modulating mechanisms may play a part (81). Remarkably, it has been observed that although paresthesia is restricted to the dermatomes of the occipital nerves, ONS efficacy is not restricted to pain in this location (52).…”

Section: Mechanism and Perspectives Of Onsmentioning

confidence: 99%

Neurostimulation in cluster headache: A review of current progress

2013

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Purpose of review: Neurostimulation has emerged as a viable treatment for intractable chronic cluster headache. Several therapeutic strategies are being investigated including stimulation of the hypothalamus, occipital nerves and sphenopalatine ganglion. The aim of this review is to provide an overview of the rationale, methods and progress for each of these. Latest findings: Results from a randomized, controlled trial investigating sphenopalatine ganglion stimulation have just been published. Reportedly the surgery is relatively simple and it is apparently the only therapy that provides relief acutely. Summary: The rationale behind these therapies is based on growing evidence from clinical, hormonal and neuroimaging studies. The overall results are encouraging, but unfortunately not all patients have benefited. All the mentioned therapies require weeks to months of stimulation for a prophylactic effect to occur, suggesting brain plasticity as a possible mechanism, and only stimulation of the sphenopalatine ganglion has demonstrated an acute, abortive effect. Predictors of effect for all modes of neurostimulation still need to be identified and in the future, the least invasive and most effective strategy must be preferred as first-line therapy for intractable chronic cluster headache.

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“…Our experimental data support this interpretation but a research group in Beiruth has provided some evidence that instead the major effect might be exerted via a supraspinal loop. 25 …”

Section: Neurophysiological Mechanisms Studied In Animal Models Of Nementioning

confidence: 99%

Mode of Action of Spinal Cord Stimulation in Neuropathic Pain

Meyerson

Linderoth

2006

Journal of Pain and Symptom Management

141

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Spinal cord stimulation emerged as a spin-off from the classical gate-control theory, which, however, does not suffice to explain its clinical effects. Whether or not nociceptive forms of pain may be attenuated remains a controversial issue. Previous experimental studies aiming at elucidating the underlying mechanisms were performed on intact, anesthetized animals and were therefore of limited clinical relevance.

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Attenuation of neuropathic pain by segmental and supraspinal activation of the dorsal column system in awake rats

Cited by 105 publications

References 35 publications

Spinal cord stimulation modulates intraspinal colorectal visceroreceptive transmission in rats

Spinal cord stimulation modulates intraspinal colorectal visceroreceptive transmission in rats

Neurostimulation in cluster headache: A review of current progress

Mode of Action of Spinal Cord Stimulation in Neuropathic Pain

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