Department of Anesthesiology & Perioperative Care, University of California, 101 The City Drive South, Orange, CA 92868, USA.
Anesth Analg. 2011 Sep;113(3):610-6. doi: 10.1213/ANE.0b013e31821e974f. Epub 2011 May 19.
Application of pulsed radiofrequency (PRF) currents to the dorsal root ganglia (DRG) has been reported to produce relief from certain pain states without causing thermal ablation. In this study, we examined the direct correlation between PRF application to DRG associated with spinal nerve injury and reversal of injury-induced behavioral hypersensitivity in a rat neuropathic pain model.
Neuropathic lesioning was performed via left L5 spinal nerve ligation on male adult Sprague-Dawley rats. Once the injured rats had developed tactile allodynia, one group was then assigned to PRF treatment of the L5 DRG and another group was assigned to the sham treatment to the DRG. Behavioral testing was performed on both the control and treated paws using the von Frey filament test before the surgery and at indicated days. The resulting data were analyzed using a linear mixed model to assess the overall difference between the treatment groups and the overall difference among the study days. Cohen's d statistic was computed from paired difference-from-baseline scores for each of the 14 study days after treatment and these measures of effect size were then used to descriptively compare the recovery patterns over time for each study group.
Spinal nerve injury resulted in the development of behavioral hypersensitivity to von Frey filament stimulation (allodynia) in the hindpaw of the left (injury) side. Mixed linear modeling showed a significant difference between the treatment groups (P = 0.0079) and a significant change of paw withdrawal threshold means over time (P = 0.0006) for all 12 animals. Evaluation of Cohen's d (effect size) revealed that the PRF-treated animals exhibited better recovery and recorded larger effect sizes than the sham-treated animals on 10 of the 14 post-PRF treatment days and exhibited moderate-to-strong effects posttreatment at days 8 to 10 and at and beyond day 32.
Findings from this study support that PRF of the DRG causes reversal of nerve injury (spinal nerve ligation)-induced tactile allodynia in rats. This allodynia reversal indicates that nonablative PRF acting via modulation of the DRG can speed recovery in nerve injury-induced pain.
已有研究报道,应用脉冲射频(PRF)电流作用于背根神经节(DRG)可缓解某些疼痛状态,而不会造成热消融。在本研究中,我们通过检测 DRG 接受 PRF 治疗与大鼠神经病理性疼痛模型中脊髓神经损伤诱导的行为性超敏反应逆转之间的直接相关性,来研究这一现象。
通过左侧 L5 脊神经结扎对雄性成年 Sprague-Dawley 大鼠进行神经损伤造模。一旦受伤大鼠出现触觉性痛觉过敏,将其中一组大鼠分配至 L5 DRG 的 PRF 治疗组,另一组分配至 DRG 的假手术治疗组。在手术前和指定天数,使用 von Frey 纤维丝测试对对照和治疗后的爪子进行行为测试。使用线性混合模型分析所得数据,以评估治疗组之间的总体差异以及研究天数之间的总体差异。对治疗后第 14 天的每个研究日的基线差值进行配对,计算 Cohen's d 统计量,并用于描述性比较每个研究组随时间的恢复模式。
脊髓神经损伤导致左侧(损伤)后爪对 von Frey 纤维丝刺激的行为性超敏反应(痛觉过敏)发展。混合线性模型显示,治疗组之间存在显著差异(P = 0.0079),并且所有 12 只动物的爪撤回阈值均值随时间变化存在显著差异(P = 0.0006)。评估 Cohen's d(效应量)发现,PRF 治疗动物在 PRF 治疗后的 14 天中有 10 天表现出更好的恢复,并且记录的效应量更大,并且在治疗后第 8 天至第 10 天以及第 32 天及以后表现出中等到强的效应。
本研究结果支持 DRG 的 PRF 可逆转大鼠神经损伤(脊神经结扎)诱导的触觉性痛觉过敏。这种痛觉过敏的逆转表明,通过调节 DRG 发挥作用的非消融性 PRF 可以加速神经损伤性疼痛的恢复。