Journal of Pain Research (Oct 2023)
Pulsed Radiofrequency 2 Hz Preserves the Dorsal Root Ganglion Neuron Physiological Ca2+ Influx, Cytosolic ATP Level, Δψm, and pERK Compared to 4 Hz: An Insight on the Safety of Pulsed Radiofrequency in Pain Management
Abstract
Ristiawan Muji Laksono,1 Taufiq Agus Siswagama,1 Fa’urinda Riam Prabu Nery,1 Walter van der Weegen,2 Willy Halim3 1Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Brawijaya University, Dr. Saiful Anwar General Hospital, Malang, Indonesia; 2Sports & Orthopedics Research Centre., St. Anna Hospital, Geldrop, the Netherlands; 3Medical Department, Faculty of Medicine, Brawijaya University, Malang, IndonesiaCorrespondence: Ristiawan Muji Laksono, Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Brawijaya University, Jl. Jaksa Agung Suprapto No. 2, Malang, East Java, Indonesia, Tel +62 812-3377-3593, Email [email protected]: Pulsed radiofrequency (PRF) is beneficial for radicular pain and is commonly administered at pulse frequencies of 2 or 4 Hz. However, its effects on healthy neurons have not yet been widely studied. This study aims to determine the effect of PRF at 2 Hz and 4 Hz on the physiology of healthy dorsal root ganglion (DRG) neurons.Methods: An in vitro experimental study was conducted using DRG neuron cultures divided into three groups. Control cells received no treatment, one cell group received 20 ms 2 Hz PRF for 360 s, and one cell group received a 4 Hz PRF 10 ms pulse for 360 s with similar energy. Ca2+ influx, mitochondrial membrane potential (Δψm), cytosolic Adenosine triphosphate (ATP), and phosphorylated extracellular signal-regulated kinase (pERK) levels were measured. The data were analyzed using the One-Way ANOVA variance with α=5%.Results: DRG neurons exposed to PRF 2 Hz did not experience a significant change in Ca2+ influx, whereas PRF 4 Hz caused a significant decrease in Ca2+ influx compared to the basal level. PRF at 2 Hz did not cause a change in Δψm, whereas PRF at 4 Hz caused a significant decrease in Δψm (p 0.05), indicating that there was no significant neuron activation.Conclusion: Both frequencies did not significantly activate DRG neurons, but with similar energy delivery, PRF 2 Hz preserved the physiological properties of healthy neurons better than PRF 4 Hz did. A 2 Hz PRF is the preferred frequency in clinical applications for neuron-targeted therapy.Keywords: pulsed radiofrequency, neurons, physiology, dorsal root ganglion neuron
