Burst Spinal Cord Stimulation in Peripherally Injured Chronic Neuropathic Rats: A Delayed Effect

Meuwissen, Koen P.V.; Gu, Jianwen Wendy; Zhang, Tianhe C.; Joosten, Elbert A.J.

doi:10.1111/papr.12701

Cited by 23 publications

(26 citation statements)

References 42 publications

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“…The motor thresholds necessary to evoke contractions of the hind paws of the animals were lower for Burst‐DRGS than Con‐DRGS in our study, albeit not significant. This is in line with preclinical findings that Burst‐SCS requires significantly lower amplitudes to obtain a motor response when compared to Con‐SCS . The latter has important consequences for the stimulation amplitude, which is generally lower with Burst‐SCS when compared to Con‐SCS .…”

Section: Discussionsupporting

confidence: 89%

“…As is the case in clinical DRGS, pain relief occurred very promptly (after 15 min of stimulation) in our animal model for both Con-DRGS and Burst-DRGS, and was maintained for the full 30 min stimulation period. Interestingly, a recent study by Meuwissen et al, which compared Con-SCS with Burst-SCS in an animal model of peripheral nerve injury, showed Burst-SCS to have a delayed onset and a delayed carry-over of analgesic effect when compared to Con-SCS (26). While no differences in terms of a delayed onset of analgesic effect was observed between Con-DRGS and Burst-DRGS in the present study, Burst-DRGS appeared to show signs of a residual effect at 45 min when compared to Con-DRGS.…”

Section: Discussionmentioning

confidence: 99%

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Dorsal Root Ganglion Stimulation in Experimental Painful Diabetic Peripheral Neuropathy: Burst vs. Conventional Stimulation Paradigm

Franken

Debets

Joosten

2019

Neuromodulation: Technology at the Neural Interface

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Objectives Painful diabetic peripheral neuropathy (PDPN) is a long‐term complication of diabetes mellitus (DM). Dorsal Root Ganglion Stimulation (DRGS) has recently emerged as a neuromodulation modality in the treatment of chronic neuropathic pain. The objective of this study was to compare the effect of burst DRGS (Burst‐DRGS) and conventional DRGS (Con‐DRGS) in an experimental model of PDPN. Materials and Methods DM was induced in female Sprague–Dawley rats by intraperitoneal injection of streptozotocin (STZ, n = 48). Animals were tested for mechanical hypersensitivity (50% hind paw withdrawal threshold on Von Frey test) before, and 4 weeks after STZ injection. PDPN rats were then implanted with a unilateral bipolar lead at the L5 DRG (n = 22) and were stimulated for 30 min at days 2 and 3 postimplantation. Animals received Con‐DRGS and Burst‐DRGS in a randomized crossover design (n = 10), or received Sham‐DRGS (n = 7) for 30 min, and were tested for mechanical hypersensitivity at baseline, 15 and 30 min during DRGS, and 15 and 30 min following DRGS. Five animals were withdrawn from the study due to electrode‐related technical problems. Results Con‐DRGS and Burst‐DRGS normalized STZ‐induced mechanical hypersensitivity at 15 and 30 min during stimulation. A significant difference in terms of mechanical hypersensitivity was observed between both of the stimulated groups and the Sham‐DRGS group at 15 and 30 min during stimulation. Interestingly, Burst‐DRGS showed signs of a residual effect at 15 min after cessation of stimulation, while this was not the case for Con‐DRGS. Conclusions Under the conditions tested, Con‐DRGS and Burst‐DRGS are equally effective in attenuating STZ‐induced mechanical hypersensitivity in an animal model of PDPN. Burst‐DRGS showed signs of a residual effect at 15 min after cessation of stimulation, which requires further investigation.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Dorsal Root Ganglion Stimulation in Experimental Painful Diabetic Peripheral Neuropathy: Burst vs. Conventional Stimulation Paradigm

Franken

Debets

Joosten

2019

Neuromodulation: Technology at the Neural Interface

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“…A unilateral ligation of the left sciatic nerve was performed as described by Seltzer et al, 29 and as previously applied in our laboratory 30‐33 . The surgery was considered successful if mechanical hypersensitivity was evident at 13 days post‐surgery, as determined by a decrease of paw withdrawal thresholds to von Frey stimuli ( 10 log [50%]) by 0.2 units compared with baseline (day 0) 30‐33 …”

Section: Methodsmentioning

confidence: 99%

“…Assessment of the paw withdrawal threshold (PWT) was performed according to the protocol described by Meuwissen et al 32,33 PWT was assessed according to the up‐down method 34 . The 50% PWT was calculated after completion of a sequence of 6 consecutive responses.…”

Section: Methodsmentioning

confidence: 99%

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Active Recharge Burst and Tonic Spinal Cord Stimulation Engage Different Supraspinal Mechanisms: A Functional Magnetic Resonance Imaging Study in Peripherally Injured Chronic Neuropathic Rats

Meuwissen

Toorn

et al. 2020

Pain Practice

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Objectives To assess the supraspinal working mechanisms of the burst spinal cord stimulation (SCS) mode, we used functional magnetic resonance imaging (fMRI) in chronic neuropathic rats. We hypothesized that active recharge burst SCS would induce a more profound blood oxygenation level–dependent (BOLD) signal increase in areas associated with cognitive‐emotional aspects of pain, as compared to tonic SCS. Methods Sprague Dawley rats (n = 17) underwent a unilateral partial sciatic nerve ligation, which resulted in chronic neuropathic pain. Quadripolar SCS electrodes were epidurally positioned on top of the dorsal columns at Th13. Isoflurane‐anesthetized (1.5%) rats received either tonic SCS (n = 8) or burst SCS (n = 9) at 66% of motor threshold. BOLD fMRI was conducted before, during, and after SCS using a 9.4‐T horizontal bore scanner. Results Overall, both tonic and burst SCS induced a significant increase of BOLD signal levels in areas associated with the location and intensity of pain, and areas associated with cognitive‐emotional aspects of pain. Additionally, burst SCS significantly increased BOLD signal levels in the raphe nuclei, nucleus accumbens, and caudate putamen. Tonic SCS did not induce a significant increase in BOLD signal levels in these areas. Conclusions In conclusion, active recharge burst and tonic SCS have different effects on the intensity and localization of SCS‐induced activation responses in the brain. This work demonstrates that active recharge burst is another waveform that can engage brain areas associated with cognitive‐emotional aspects of pain as well as areas associated with location and intensity of pain. Previous studies showing similar engagement used only passive recharge burst.

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Programming—SCS

Gu¹

2022

Essential Neuromodulation

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Burst Spinal Cord Stimulation in Peripherally Injured Chronic Neuropathic Rats: A Delayed Effect

Abstract: To conclude, biphasic burst SCS results in a delayed antinociceptive effect after onset of the stimulation, as compared with Con SCS, in a chronic neuropathic pain model. Furthermore, biphasic burst SCS seems to exhibit a delayed wash-out of analgesia after stimulation is turned off.

Cited by 23 publications

References 42 publications

Dorsal Root Ganglion Stimulation in Experimental Painful Diabetic Peripheral Neuropathy: Burst vs. Conventional Stimulation Paradigm

Dorsal Root Ganglion Stimulation in Experimental Painful Diabetic Peripheral Neuropathy: Burst vs. Conventional Stimulation Paradigm

Active Recharge Burst and Tonic Spinal Cord Stimulation Engage Different Supraspinal Mechanisms: A Functional Magnetic Resonance Imaging Study in Peripherally Injured Chronic Neuropathic Rats

Programming—SCS

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