Objectives: Models that simulate clinical conditions are needed to gain an understanding of the mechanism involved during spinal cord stimulation (SCS) treatment of chronic neuropathic pain. An animal model has been developed for continuous SCS in which animals that have been injured to develop neuropathic pain behavior were allowed to carry on with regular daily activities while being stimulated for 72 hours.
Material And Methods: Sprague-Dawley rats were randomized into each of six different groups (N = 10-13). Three groups included animals in which the spared nerve injury (SNI) was induced. Animals in two of these groups were implanted with a four-contact electrode in the epidural space. Animals in one of these groups received stimulation for 72 hours continuously. Three corresponding sham groups (no SNI) were included. Mechanical and cold-thermal allodynia were evaluated using von Frey filaments and acetone drops, respectively. Mean withdrawal thresholds were compared. Statistical significance was established using one-way ANOVAs followed by Holm-Sidak post hoc analysis.
Results: Continuous SCS attenuates mechanical allodynia in animals with neuropathic pain behavior. Mechanical withdrawal threshold increases significantly in SNI animals after 24 and 72 hours stimulation vs. SNI no stimulation (p = 0.007 and p < 0.001, respectively). SCS for 24 and 72 hours provides significant increase in mechanical withdrawal thresholds relative to values before stimulation (p = 0.001 and p < 0.001, respectively). Stimulation did not provide recovery to baseline values. SCS did not seem to attenuate cold-thermal allodynia.
Conclusion: A continuous SCS model has been developed. Animals with neuropathic pain behavior that were continuously stimulated showed significant increase in withdrawal thresholds proportional to stimulation time.
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http://dx.doi.org/10.1111/ner.12280 | DOI Listing |
FASEB J
January 2025
Department of Physiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Neuropathic pain, caused by nerve damage, greatly affects quality of life. Recent research proposes modulating brain activity, particularly through electrical stimulation of the insular cortex (IC), as a treatment option. This study aimed to understand how IC stimulation (ICS) affects pain modulation.
View Article and Find Full Text PDFBr J Hosp Med (Lond)
December 2024
Department of Neurology, Huai'an Hospital of Huai'an City, Huai'an, Jiangsu, China.
Postherpetic neuralgia (PHN) is a common chronic pain disease that persists after the rash (clusters of clear blisters on the surface of the skin) has healed, adversely affecting the quality of life of affected patients. Gabapentin (GPT) and pregabalin (PGB) are two commonly used drugs for the treatment of PHN, but there have been broad concerns regarding their efficacy and safety. Thus, this retrospective cohort study was conducted to investigate the effectiveness and safety of GPT versus PGB in the treatment of PHN.
View Article and Find Full Text PDFJ Thorac Dis
December 2024
Department of Anaesthesiology, Critical Care and Pain Medicine, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany.
Background: Moderate to severe postoperative pain is common among patients following thoracotomy and serves as a risk factor for developing chronic post-thoracotomy pain (CPTP). This randomized controlled trial evaluated the effects of pre-emptively administered ketamine compared to placebo and standard care on both acute postoperative pain and CPTP.
Methods: Two hundred patients were enrolled in this prospective, randomized trial.
Orthop Rev (Pavia)
January 2025
Department of Anesthesiology, Critical Care, and Pain Medicine The University of Texas Health Science Center at Houston.
Headaches are among the most prevalent medical complaints globally. Occipital neuralgia is a chronic headache disorder characterized by unilateral or bilateral severe pain originating in the neck or skull base and radiating up along the occipital nerve distribution. Effective treatment options for occipital neuralgia can be challenging and some patients may prove to be refractory to conventional medical and interventional therapies.
View Article and Find Full Text PDFCureus
December 2024
Neurosurgery, Desert Regional Medical Center, Palm Springs, USA.
Microvascular decompression (MVD) is a neurosurgical operation used to treat trigeminal neuralgia (TN). The surgery is performed through a retrosigmoid approach, where a Teflon pledget is placed in between the offending vessel (most commonly the superior cerebellar artery) and trigeminal nerve. The surgery is performed within the superior aspect of the cerebellopontine angle (CPA) through a small working corridor that is triangulated by the petrous bone and tentorium.
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