Dewberry Lauren Savannah, Porche Ken, Koenig Travis, Allen Kyle D, Otto Kevin J
J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1275 Center Dr. JG56, P.O. Box 116131, Gainesville, FL, 32611, USA.
Lillian S Wells Department of Neurosurgery at the University of Florida, College of Medicine, 1505 SW Archer Road Gainesville, FL, 32608, Gainesville, USA.
Bioelectron Med. 2023 Jul 12;9(1):15. doi: 10.1186/s42234-023-00119-0.
The purpose of this study was to evaluate if kilohertz frequency alternating current (KHFAC) stimulation of peripheral nerve could serve as a treatment for lumbar radiculopathy. Prior work shows that KHFAC stimulation can treat sciatica resulting from chronic sciatic nerve constriction. Here, we evaluate if KHFAC stimulation is also beneficial in a more physiologic model of low back pain which mimics nucleus pulposus (NP) impingement of a lumbar dorsal root ganglion (DRG).
To mimic a lumbar radiculopathy, autologous tail NP was harvested and placed upon the right L5 nerve root and DRG. During the same surgery, a cuff electrode was implanted around the sciatic nerve with wires routed to a headcap for delivery of KHFAC stimulation. Male Lewis rats (3 mo., n = 18) were separated into 3 groups: NP injury + KHFAC stimulation (n = 7), NP injury + sham cuff (n = 6), and sham injury + sham cuff (n = 5). Prior to surgery and for 2 weeks following surgery, animal tactile sensitivity, gait, and static weight bearing were evaluated.
KHFAC stimulation of the sciatic nerve decreased behavioral evidence of pain and disability. Without KHFAC stimulation, injured animals had heightened tactile sensitivity compared to baseline (p < 0.05), with tactile allodynia reversed during KHFAC stimulation (p < 0.01). Midfoot flexion during locomotion was decreased after injury but improved with KHFAC stimulation (p < 0.05). Animals also placed more weight on their injured limb when KHFAC stimulation was applied (p < 0.05). Electrophysiology measurements at end point showed decreased, but not blocked, compound nerve action potentials with KHFAC stimulation (p < 0.05).
KHFAC stimulation decreases hypersensitivity but does not cause additional gait compensations. This supports the idea that KHFAC stimulation applied to a peripheral nerve may be able to treat chronic pain resulting from sciatic nerve root inflammation.
本研究的目的是评估外周神经的千赫兹频率交流电（KHFAC）刺激是否可作为腰椎神经根病的一种治疗方法。先前的研究表明，KHFAC刺激可治疗由慢性坐骨神经压迫引起的坐骨神经痛。在此，我们评估KHFAC刺激在模拟腰椎间盘突出症（NP）对腰背根神经节（DRG）造成压迫的更符合生理的腰痛模型中是否也有益处。
为模拟腰椎神经根病，采集自体尾NP并置于右侧L5神经根和DRG上。在同一手术过程中，将袖带电极植入坐骨神经周围，导线连接到头帽以进行KHFAC刺激。将雄性Lewis大鼠（3个月龄，n = 18）分为3组：NP损伤 + KHFAC刺激组（n = 7）、NP损伤 + 假袖带组（n = 6）和假损伤 + 假袖带组（n = 5）。在手术前以及手术后2周，评估动物的触觉敏感性、步态和静态负重情况。
坐骨神经的KHFAC刺激减少了疼痛和功能障碍的行为证据。在没有KHFAC刺激的情况下，与基线相比，受伤动物的触觉敏感性增强（p < 0.05），而在KHFAC刺激期间触觉异常性疼痛得到逆转（p < 0.01）。运动过程中的中足屈曲在受伤后减少，但在KHFAC刺激下有所改善（p < 0.05）。当施加KHFAC刺激时，动物在受伤肢体上施加的重量也更多（p < 0.05）。终点时的电生理测量显示，KHFAC刺激使复合神经动作电位降低，但未阻断（p < 0.05）。
KHFAC刺激可降低超敏反应，但不会导致额外的步态代偿。这支持了对外周神经施加KHFAC刺激可能能够治疗坐骨神经根部炎症引起的慢性疼痛这一观点。
