Dorsal Column Stimulation in Man

Shimoji, Koki; Shimizu, Hiroyuki; Maruyama, Y; Matsuki, Michiko; Kuribayashi, Hideki; Fujioka, Hitoshi

doi:10.1213/00000539-198205000-00003

Cited by 31 publications

(11 citation statements)

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“…7). Habituation is consistent with (though not exclusive to) synaptic processes (Sdrulla et al, 2015;Shimoji et al, 1982) and is also shown for superficial dorsal horn interneuron responses to 50 Hz SCS (Fan et al, 2022).…”

Section: Origin and Significance Of S1 Esapssupporting

confidence: 79%

“…Background supporting the hypothesis that ESAPs reflect local circuit processing are wide-ranging experiments on spinal evoked (cord dorsum) potentials (Maruyama et al, 1982; Ondrejcák et al, 2005; Shimoji et al, 1982; Tomita et al, 1996; Yates et al, 1982); a ∼2 ms “triphasic spike” (attributed to axonal conduction, e.g., ECAPs), ∼5 ms “negative wave” (attributed to synaptic afferents / interneuron activity) and then a tens of ms “positive wave” (attributed to synaptic “primary afferent depolarization (PAD)” or presynaptic inhibition) have been reported. That the properties of the ESAP are sensitive to the frequency of applied SCS—with higher frequencies (i.e., 50 Hz) producing adaptation of ESAP but not ECAP—corroborates either an adapting excitatory synaptic mechanism or a result of PAD, i.e., presynaptic inhibition of excitatory afferents, as the underlying mechanism of generation.…”

Section: Discussionmentioning

confidence: 99%

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Novel Evoked Synaptic Activity Potentials (ESAPs) elicited by Spinal Cord Stimulation

Sharma

Bhaskar

Yang

et al. 2023

Preprint

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Spinal cord stimulation (SCS) evokes fast epidural Evoked Compound Action Potential (ECAPs) that represent activity of dorsal column axons, but not necessarily a spinal circuit response. Using a multimodal approach, we identified and characterized a delayed and slower potential evoked by SCS that reflects synaptic activity within the spinal cord. Anesthetized female Sprague Dawley rats were implanted with an epidural SCS lead, epidural motor cortex stimulation electrodes, an epidural spinal cord recoding lead, an intraspinal penetrating recording electrode array, and intramuscular electromyography (EMG) electrodes in the hindlimb and back. We stimulated the motor cortex or the epidural spinal cord and recorded epidural, intraspinal, and EMG responses. SCS pulses produced characteristic propagating ECAPs (composed of P1, N1, and P2 waves with latencies <2 ms) and an additional wave (S1) starting after the N2. We verified the S1-wave was not a stimulation artifact and was not a reflection of hindlimb/back EMG. The S1-wave has a distinct stimulation-intensity dose response and spatial profile compared to ECAPs. CNQX (a selective competitive antagonist of AMPA receptors) significantly diminished the S1-wave, but not ECAPs. Furthermore, cortical stimulation, which did not evoke ECAPs, produced epidurally detectable and CNQX-sensitive responses at the same spinal sites, confirming epidural recording of an evoked synaptic response. Finally, applying 50 Hz SCS resulted in dampening of ESAPs, but not ECAPs. Therefore, we hypothesize that the S1-wave is synaptic in origin, and we term the S1-wave type responses: Evoked Synaptic Activity Potentials (ESAPs). The identification and characterization of epidurally recorded ESAPs from the dorsal horn may elucidate SCS mechanisms.

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Section: Origin and Significance Of S1 Esapssupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Novel Evoked Synaptic Activity Potentials (ESAPs) elicited by Spinal Cord Stimulation

Sharma

Bhaskar

Yang

et al. 2023

Preprint

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“…wall [37], но общий принцип модели воротного контроля остается в силе [38]. Однако на уровне спин-ного мозга действует и другой механизм: антидромное проведение по волокнам задних столбов может на-прямую приводить к деполяризации нейронов задних рогов и вызывать вследствие этого пост-и пресинапти-ческое торможение входящих афферентных стимулов [39].…”

Section: механизм действия и прямые эффекты спинальной нейростимуляцииunclassified

“…2017;21(2):29-42 DOI: 10.21688-1681-3472-2017-2- [29][30][31][32][33][34][35][36][37][38][39][40][41][42] сравнении с консервативной терапией. Единственным исключением среди рандомизированных исследова-ний является работа H.M. Klomp и соавторов [62], ко-торые не получили значимых различий между группами SCS и консервативной терапии.…”

Section: Reviewsunclassified

Spinal cord stimulation in treatment of patients with critical lower limb ischemia

Ashurkov¹,

Levin²,

Murtazin³

et al. 2017

PKiK

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Critical limb ischemia (CLI) is a state of substantial reduction of blood flow in the extremities, mostly due to severe obstruction of the arteries. In lower limbs, it produces severe pain after even a short distance walk (intermittent claudication) and/or skin ulcers or sores. Surgical revascularization is a “golden standard” in CLI therapy, but it is contraindicated or not accessible for a large proportion of patients, while the medical prognosis is poor for conservative therapy. This situation stimulated the development of alternative approaches, including spinal cord stimulation (SCS) and various methods of “indirect” revascularization. In this paper, the authors give a short description of the latest approaches and a detailed review of the SCS method, while paying special attention to the studies that demonstrate not only a palliative effect of SCS (pain reduction), but also clinically significant changes in the indicators of lower limb muscles blood supply. CLI is characterized with a "vicious circle": pain causes reduced mobility and changes in the preferred limb position, which in turn lead to edema triggering an increase of ischemia and further elevation of pain. The clinical effects of SCS in CLI patients are related both with pain relief leading to a break of this vicious circle, and with the direct vasodilatory effects of the stimulation itself. There are several possible biological mechanisms of these actions, but most probably the therapeutic actions of SCS arise from their combination. Examination of different opinions about the appropriateness of spinal cord stimulation in patients with CLI, including those related to the economic efficiency of the method, leads to the conclusion that the evidence on these issues is currently insufficient. The reviewed data demonstrate the need for further development of the CLI treatment methods and high urgency of this problem.Received 6 April 2017. Accepted 23 April 2017.Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest.

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“…It was suggested that SCS could stimulate at least five descending excitatory pathways with different conduction velocities [22]. Shimoji et al suggested the activation of the dorsolateral funiculus and other descending tracts as a supraspinal mechanism of action of SCS [65]. Several studies denoted the influence of SCS on the descending serotonergic pathways [34,36] and the reduced GABA-mediated inhibition of PAG output neurons, leading to an increase of activity in the descending inhibitory pathways [24,35].…”

Section: Scientific Support For This Hypothesismentioning

confidence: 99%

Exploration of the Supraspinal Hypotheses about Spinal Cord Stimulation and Dorsal Root Ganglion Stimulation: A Systematic Review

Goudman

Groote

Linderoth

et al. 2021

JCM

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Despite the established efficacy and effectiveness of Spinal Cord Stimulation (SCS), there is still no consensus on the supraspinal mechanisms of action of this therapy. The purpose of this study was to systematically review previously raised hypotheses concerning supraspinal mechanisms of action of SCS based on human, animal and computational studies. Searches were conducted using four electronic databases (PubMed, EMBASE, SCOPUS and Web of Science), backward reference searching and consultation with experts. The study protocol was registered prior to initiation of the review process (PROSPERO CRD42020161531). A total of 54 publications were included, 21 of which were animal studies, and 33 were human studies. The supraspinal hypotheses (n = 69) identified from the included studies could be categorized into six groups concerning the proposed supraspinal hypothesis, namely descending pathways (n = 24); ascending medial pathway (n = 13); ascending lateral pathway (n = 10); affective/motivational influences (n = 8); spinal–cerebral (thalamic)-loop (n = 3) and miscellaneous (n = 11). Scientific support is provided for the hypotheses identified. Modulation of the descending nociceptive inhibitory pathways, medial and lateral pathways were the most frequently reported hypotheses about the supraspinal mechanisms of action of SCS. These hypotheses were mainly supported by studies with a high or moderate confidence in the body of evidence.

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Dorsal Column Stimulation in Man

Cited by 31 publications

References 0 publications

Novel Evoked Synaptic Activity Potentials (ESAPs) elicited by Spinal Cord Stimulation

Novel Evoked Synaptic Activity Potentials (ESAPs) elicited by Spinal Cord Stimulation

Spinal cord stimulation in treatment of patients with critical lower limb ischemia

Exploration of the Supraspinal Hypotheses about Spinal Cord Stimulation and Dorsal Root Ganglion Stimulation: A Systematic Review

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