Laboratory of Neuroscience, Hospital Sírio-Libanês, São Paulo, Brazil.
Acupuncture Center, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
Acupunct Med. 2022 Apr;40(2):169-177. doi: 10.1177/09645284211055751. Epub 2021 Nov 10.
Neuropathic pain (NP) is a complex disease that remains challenging to treat. Low-frequency dense-and-disperse (DD) electroacupuncture (EA) has been used as adjuvant therapy for neuropathic pain; however, its analgesic effect decreases as stimulation time increases, or when it is repeatedly used. We hypothesized that a new frequency parameter could improve the effectiveness of EA, and aimed to compare the efficacy and duration of the analgesic effect between classic DD-EA and non-repetitive and non-sequential frequency (random frequency (RF)-EA) in neuropathic rats. Furthermore, the effect of RF-EA at local traditional acupuncture point locations versus auricular vagus nerve stimulation (aVNS) was evaluated.
Male Wistar rats with peripheral neuropathy were subjected to a single session of DD-EA or RF-EA for 20 or 40 min at ST36 + GB34. An additional group of rats was treated with RF-EA for 20 min using aVNS at the appropriate ear point locations. Paw pressure test, von Frey filaments and spontaneous pain scores were evaluated. Sham-operated rats were used as controls.
In all, 20 min of RF-EA reversed hyperalgesia (for 24 h) and allodynia (for 8 h), showing a longer analgesic effect than DD-EA. Both RF-EA and DD-EA induced partial inhibition of spontaneous pain for 8 h. Forty minutes of DD-EA did not interfere with the NP phenomena; however, RF-EA induced significant long-term analgesia. aVNS induced an analgesic effect similar to local stimulation.
This pilot study shows that RF-EA at both local traditional acupuncture point and auriculotherapy point locations induces long-lasting analgesia in neuropathic rats, and more effectively so than classical DD-EA.
神经性疼痛(NP)是一种复杂的疾病,仍然难以治疗。低频密集分散(DD)电针(EA)已被用作治疗神经性疼痛的辅助疗法;然而,随着刺激时间的增加或重复使用,其镇痛效果会降低。我们假设一个新的频率参数可以提高 EA 的有效性,并旨在比较经典 DD-EA 和非重复非连续频率(随机频率(RF)-EA)在神经性大鼠中的疗效和镇痛效果持续时间。此外,还评估了 RF-EA 在局部传统穴位与耳迷走神经刺激(aVNS)之间的效果。
雄性 Wistar 大鼠患有周围神经病变,单次接受 DD-EA 或 RF-EA 治疗,ST36+GB34 处 20 或 40 分钟。另有一组大鼠使用适当的耳点位置的 aVNS 进行 20 分钟的 RF-EA 治疗。评估爪压力测试、von Frey 细丝和自发性疼痛评分。假手术大鼠用作对照。
总共 20 分钟的 RF-EA 逆转了痛觉过敏(持续 24 小时)和痛觉过敏(持续 8 小时),表现出比 DD-EA 更长的镇痛效果。RF-EA 和 DD-EA 均诱导 8 小时自发性疼痛的部分抑制。40 分钟的 DD-EA 不会干扰 NP 现象;然而,RF-EA 诱导了显著的长期镇痛作用。aVNS 诱导了类似于局部刺激的镇痛作用。
这项初步研究表明,局部传统穴位和耳穴部位的 RF-EA 均可在神经性大鼠中诱导持久的镇痛作用,其效果比经典 DD-EA 更有效。