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使用注射电极通过背根神经节刺激募集初级传入神经。

Recruitment of Primary Afferents by Dorsal Root Ganglion Stimulation using the Injectrode.

作者信息

Dalrymple Ashley N, Ting Jordyn E, Bose Rohit, Nieuwoudt Stephan, Franke Manfred, Ludwig Kip A, Shoffstall Andrew J, Fisher Lee E, Weber Douglas J

机构信息

Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.

Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Int IEEE EMBS Conf Neural Eng. 2021 May;2021:609-612. doi: 10.1109/ner49283.2021.9441420. Epub 2021 Jun 2.

DOI:10.1109/ner49283.2021.9441420
PMID:34630868
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8502004/
Abstract

Chronic pain affects millions of people in the United States and pharmacological treatments have been ineffective. Dorsal root ganglion (DRG) stimulation is a neuromodulation method that delivers electrical stimulation to the DRG to relieve pain. DRG electrodes are rigid and cylindrical. The implantation of DRG electrodes requires a technically-challenging surgery that involves steering electrodes laterally towards the DRG. The Injectrode is an injectable conductive polymer that cures in place and is capable of delivering electrical current to stimulate neural tissue. We used the Injectrode to stimulate the L6 and L7 DRG in cats, measuring neural responses evoked in the sciatic, tibial, and common peroneal nerves to measure the thresholds for activating fibers. A cylindrical stainless-steel electrode was used for comparison. Thresholds were 38% higher with the Injectrode versus stainless-steel, likely owing to its larger contact surface area with the DRG. Both Aα and Aβ sensory fibers were activated using DRG stimulation. The Injectrode has the potential to offer a new and simple method for DRG stimulation that can potentially offer more complete coverage of the DRG.

摘要

慢性疼痛影响着美国数百万人,而药物治疗一直无效。背根神经节(DRG)刺激是一种神经调节方法,通过向DRG输送电刺激来缓解疼痛。DRG电极是刚性圆柱形的。植入DRG电极需要进行一项技术要求很高的手术,该手术涉及将电极侧向引导至DRG。注射式电极是一种可注射的导电聚合物,可在原位固化,并能够输送电流以刺激神经组织。我们使用注射式电极刺激猫的L6和L7 DRG,测量坐骨神经、胫神经和腓总神经中诱发的神经反应,以测量激活纤维的阈值。使用圆柱形不锈钢电极作为对照。与不锈钢电极相比,注射式电极的阈值高38%,这可能是由于其与DRG的接触表面积更大。使用DRG刺激可激活Aα和Aβ感觉纤维。注射式电极有可能为DRG刺激提供一种新的、简单的方法, potentially offering more complete coverage of the DRG.(原文此处表述有误,正确翻译为“有可能为DRG提供更全面的覆盖”)

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本文引用的文献

1
An Injectable Neural Stimulation Electrode Made from an In-Body Curing Polymer/Metal Composite.一种由体内固化聚合物/金属复合材料制成的可注射神经刺激电极。
Adv Healthc Mater. 2019 Dec;8(23):e1900892. doi: 10.1002/adhm.201900892. Epub 2019 Nov 7.
2
Selectivity of afferent microstimulation at the DRG using epineural and penetrating electrode arrays.使用神经外膜和穿透电极阵列在 DRG 处进行传入微刺激的选择性。
J Neural Eng. 2019 Dec 13;17(1):016011. doi: 10.1088/1741-2552/ab4a24.
3
Spinal cord stimulation in chronic pain: evidence and theory for mechanisms of action.慢性疼痛中的脊髓刺激:作用机制的证据与理论
Bioelectron Med. 2019 Jun 28;5. doi: 10.1186/s42234-019-0023-1.
4
Considerations in addressing the opioid epidemic and chronic pain within the USA.美国应对阿片类药物流行和慢性疼痛的考量因素。
Pain Manag. 2019 Mar 1;9(2):131-138. doi: 10.2217/pmt-2018-0070. Epub 2019 Feb 26.
5
The Efficacy and Safety of Dorsal Root Ganglion Stimulation as a Treatment for Neuropathic Pain: A Literature Review.背根神经节刺激治疗神经性疼痛的疗效与安全性:文献综述
Neuromodulation. 2018 Apr;21(3):225-233. doi: 10.1111/ner.12685. Epub 2017 Sep 28.
6
Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial.背根神经节刺激术在3个月和12个月时对复杂性区域疼痛综合征和灼性神经痛的治疗成功率更高:一项随机对照试验。
Pain. 2017 Apr;158(4):669-681. doi: 10.1097/j.pain.0000000000000814.
7
Microstimulation of the lumbar DRG recruits primary afferent neurons in localized regions of lower limb.对腰段背根神经节进行微刺激可募集下肢局部区域的初级传入神经元。
J Neurophysiol. 2016 Jul 1;116(1):51-60. doi: 10.1152/jn.00961.2015. Epub 2016 Apr 6.
8
Estimates of pain prevalence and severity in adults: United States, 2012.2012年美国成年人疼痛患病率及严重程度估计
J Pain. 2015 Aug;16(8):769-80. doi: 10.1016/j.jpain.2015.05.002. Epub 2015 May 29.
9
Chronic recruitment of primary afferent neurons by microstimulation in the feline dorsal root ganglia.猫背根神经节中微刺激对初级传入神经元的慢性募集
J Neural Eng. 2014 Jun;11(3):036007. doi: 10.1088/1741-2560/11/3/036007. Epub 2014 Apr 24.
10
A prospective study of dorsal root ganglion stimulation for the relief of chronic pain.一项关于背根神经节刺激缓解慢性疼痛的前瞻性研究。
Neuromodulation. 2013 Jan-Feb;16(1):67-71; discussion 71-2. doi: 10.1111/ner.12013. Epub 2012 Dec 14.