Biomedicines (May 2021)

Differential Modulation of Dorsal Horn Neurons by Various Spinal Cord Stimulation Strategies

  • Kwan Yeop Lee,
  • Dongchul Lee,
  • Zachary B. Kagan,
  • Dong Wang,
  • Kerry Bradley

DOI
https://doi.org/10.3390/biomedicines9050568
Journal volume & issue
Vol. 9, no. 5
p. 568

Abstract

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New strategies for spinal cord stimulation (SCS) for chronic pain have emerged in recent years, which may work better via different analgesic mechanisms than traditional low-frequency (e.g., 50 Hz) paresthesia-based SCS. To determine if 10 kHz and burst SCS waveforms might have a similar mechanistic basis, we examined whether these SCS strategies at intensities ostensibly below sensory thresholds would modulate spinal dorsal horn (DH) neuronal function in a neuron type-dependent manner. By using an in vivo electrophysiological approach in rodents, we found that low-intensity 10 kHz SCS, but not burst SCS, selectively activates inhibitory interneurons in the spinal DH. This study suggests that low-intensity 10 kHz SCS may inhibit pain-sensory processing in the spinal DH by activating inhibitory interneurons without activating DC fibers, resulting in paresthesia-free pain relief, whereas burst SCS likely operates via other mechanisms.

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