Suppr超能文献

周围抑制介导低频脊髓刺激的镇痛作用:建模与测量。

Surround Inhibition Mediates Pain Relief by Low Amplitude Spinal Cord Stimulation: Modeling and Measurement.

机构信息

Department of Biomedical Engineering, Duke University, Durham, NC, 27708.

Neuromodulation Research and Advanced Concepts, Boston Scientific Neuromodulation, Valencia, CA, 91355.

出版信息

eNeuro. 2022 Oct 5;9(5). doi: 10.1523/ENEURO.0058-22.2022. Print 2022 Sep-Oct.

Abstract

Low-frequency (<200 Hz), subperception spinal cord stimulation (SCS) is a novel modality demonstrating therapeutic efficacy for treating chronic neuropathic pain. When stimulation parameters were carefully titrated, patients experienced rapid onset (seconds-minutes) pain relief without paresthesia, but the mechanisms of action are unknown. Using an integrated computational model and in vivo measurements in urethane-anesthetized rats, we quantified how stimulation parameters (placement, pulse width, frequency, and amplitude) influenced dorsal column (DC) axon activation and neural responses in the dorsal horn (DH). Both modeled and recorded DC axons responded with irregular spiking patterns in response to low-amplitude SCS. Maximum inhibition of DH neurons occurred at ∼80% of the predicted sensory threshold in both modeled and recorded neurons, and responses were strongly dependent on spatially targeting of stimulation, i.e., the complement of DC axons activated, and on stimulation parameters. Intrathecal administration of bicuculline shifted neural responses to low-amplitude stimulation in both the model and experiment, suggesting that analgesia is dependent on segmental GABAergic mechanisms. Our results support the hypothesis that low-frequency subperception SCS generates rapid analgesia by activating a small number of DC axons which inhibit DH neuron activity via surround inhibition.

摘要

低频(<200Hz)、亚感知脊髓刺激(SCS)是一种新的治疗模式,证明对治疗慢性神经性疼痛有效。当刺激参数被仔细滴定时,患者会迅速出现(秒-分钟)疼痛缓解而没有感觉异常,但作用机制尚不清楚。使用综合计算模型和在麻醉的尿嘧啶大鼠体内测量,我们量化了刺激参数(位置、脉冲宽度、频率和幅度)如何影响背柱(DC)轴突激活和背角(DH)中的神经反应。模型和记录的 DC 轴突都以不规则的爆发模式对低幅度 SCS 作出反应。在模型和记录神经元中,DH 神经元的最大抑制发生在预测感觉阈值的约 80%,并且反应强烈依赖于刺激的空间靶向,即激活的 DC 轴突的补充,以及刺激参数。鞘内给予 Bicuculline 会在模型和实验中改变低幅度刺激的神经反应,这表明镇痛依赖于节段性 GABA 能机制。我们的结果支持这样的假设,即低频亚感知 SCS 通过激活少量 DC 轴突产生快速镇痛,这些轴突通过环绕抑制抑制 DH 神经元的活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5776/9536854/9d248fdbf9e7/ENEURO.0058-22.2022_f001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验