High frequency alternating current neurostimulation decreases nocifensive behavior in a disc herniation model of lumbar radiculopathy.
High frequency alternating current neurostimulation decreases nocifensive behavior in a disc herniation model of lumbar radiculopathy.
复制标题
高频交替的电流神经刺激会降低腰椎椎间盘突出模型中的单化行为。
DOI：
10.1186/s42234-023-00119-0
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发表时间：
2023-07-12
影响因子：
--
通讯作者：
Otto, Kevin J
中科院分区：
文献类型：
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作者：
Dewberry, Lauren Savannah;Porche, Ken;Koenig, Travis;Allen, Kyle D;Otto, Kevin J
本研究的目的是评估是否千赫频率交流电（KHFAC）周围神经刺激可以作为一种治疗腰椎神经根病。先前的工作表明，KHFAC刺激可以治疗由慢性坐骨神经收缩引起的坐骨神经痛。在这里，我们评估KHFAC刺激是否也有益于模拟腰椎背根神经节（DRG）的髓核（NP）撞击的腰痛的生理模型。为了模拟腰椎神经根病，采集自体尾部NP并置于右侧L5神经根和DRG上。在同一手术期间，将袖带电极植入坐骨神经周围，其中导线路由到头帽以递送KHFAC刺激。雄性刘易斯大鼠（3个月，将18只大鼠分为3组：NP损伤+ KHFAC刺激组（n = 7）、NP损伤+假袖套组（n = 6）和假损伤+假袖套组（n = 5）。术前和术后2周，评价动物触觉敏感性、步态和静态负重。坐骨神经的KHFAC刺激减少疼痛和残疾的行为证据。在没有KHFAC刺激的情况下，与基线相比，受伤的动物具有提高的触觉敏感性（p < 0.05），触觉异常性疼痛在KHFAC刺激期间逆转（p < 0.01）。运动过程中的足中屈曲在损伤后减少，但在KHFAC刺激下得到改善（p < 0.05）。当施加KHFAC刺激时，动物还将更多的重量放在其受伤的肢体上（p < 0.05）。终点电生理学测量显示KHFAC刺激的复合神经动作电位降低，但未被阻断（p < 0.05）。KHFAC刺激可降低超敏反应，但不会引起额外的步态补偿。这支持了这样的想法，即施加到外周神经的KHFAC刺激可能能够治疗由坐骨神经根炎症引起的慢性疼痛。
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.