Somers David L, Clemente F Richard
Department of Physical Therapy, John G. Rangos Sr School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA.
J Pain. 2009 Feb;10(2):221-9. doi: 10.1016/j.jpain.2008.08.008. Epub 2008 Nov 17.
The purpose of the study was to examine the effect of 3 different application strategies for transcutaneous electrical nerve stimulation (TENS) on neuropathy-induced allodynia and dorsal horn neurotransmitter content. Rats were treated with high-frequency, low-frequency, or a combination of high and low-frequency stimulation. TENS was delivered through self-adhesive electrodes daily for 1 hour to rats with a right-sided chronic constriction injury (CCI). Stimulation was delivered to skin or acupuncture points on the left and mechanical and thermal pain thresholds were assessed in the right hind paw. Neurotransmitter content was assessed bilaterally in the dorsal horn of the spinal cord. Daily, high-frequency or a combination of high- and low-frequency TENS reduced mechanical (P < .001), but not thermal allodynia in the right hind paw when compared with untreated CCI rats. Daily high frequency TENS elevated the dorsal horn synaptosomal content of GABA bilaterally (P < .014) and a combination of high- and low-frequency TENS elevated the dorsal horn content of aspartate (P < .001), glutamate (P < .001) and glycine (P < .001) bilaterally over that seen in untreated CCI rats. The present findings support a contralateral approach to the application of TENS and suggest that distinct strategies for TENS application may differentially alter neurotransmission in the central nervous system.
Because CCI rats are reminiscent of humans with neuropathy, daily high or a combination of high- and low-frequency TENS may reduce mechanical allodynia in humans with neuropathic pain. Because the 2 intervention strategies produce distinctive alterations in spinal cord neurotransmitter content, each may represent a distinctive option for treatment.
本研究的目的是检验经皮电刺激神经疗法(TENS)的三种不同应用策略对神经病变引起的异常性疼痛和背角神经递质含量的影响。对大鼠进行高频、低频或高低频联合刺激。通过自粘电极每天给右侧慢性缩窄性损伤(CCI)大鼠进行1小时的TENS治疗。刺激施加于左侧皮肤或穴位,并评估右侧后爪的机械性和热痛阈值。双侧评估脊髓背角的神经递质含量。与未治疗的CCI大鼠相比,每天进行高频或高低频联合TENS治疗可降低右侧后爪的机械性疼痛(P <.001),但不能降低热异常性疼痛。每天进行高频TENS治疗可使双侧背角突触体GABA含量升高(P <.014),高低频联合TENS治疗可使双侧背角天冬氨酸(P <.001)、谷氨酸(P <.001)和甘氨酸(P <.001)含量高于未治疗的CCI大鼠。本研究结果支持TENS应用的对侧方法,并表明TENS应用的不同策略可能对中枢神经系统的神经传递产生不同影响。
由于CCI大鼠类似于患有神经病变的人类,每天进行高频或高低频联合TENS治疗可能会减轻神经性疼痛患者的机械性异常性疼痛。由于这两种干预策略在脊髓神经递质含量上产生独特的变化,每种策略可能代表一种独特的治疗选择。