Spinal stimulation for motor rehabilitation immediately modulates nociceptive transmission.
Spinal stimulation for motor rehabilitation immediately modulates nociceptive transmission.
复制标题
DOI：
10.1088/1741-2552/ac9a00
复制
发表时间：
2022-10-31
影响因子：
4
通讯作者：
McPherson, Jacob G.
中科院分区：
文献类型：
--
作者：
Bandres, Maria F.;Gomes, Jefferson L.;McPherson, Jacob G.
关键词：
脊髓损伤(SCI)常导致衰弱的运动障碍和神经病理性疼痛。电刺激脊髓神经元在增强弱化运动通路中的神经传递和减少过度活跃的伤害性感受通路中的神经传递两方面都有相当大的前景。然而，目前正在为脊髓损伤患者开发的脊髓刺激范例仍然压倒性地仅在运动康复的背景下开发。本研究的目的是验证运动靶向脊髓刺激同时调节脊髓伤害性信息传递的假设。我们研究了运动靶向脊髓内微刺激(ISMS)对大量离散的、伤害性的、特定的和大动态范围神经元的放电动力学的神经调制作用。通过体内植入大鼠腰椎膨大的致密微电极阵列获得神经元。通过机械探查L5皮肤刀，在ISM前、中和后诱导伤害性和非伤害性皮肤传播。我们的主要发现是：(1)传递到脊髓运动池的亚运动阈值ISM立即调节同时的伤害性传递；(2)抗伤害性效应的幅度随着ISM持续时间的延长而增加，包括强烈的延续效应；(3)大多数已发现的伤害性特异性和大动态范围的神经元在ISM仅10分钟后就表现出放电频率的降低；以及(4)ISMS不增加脊髓对非伤害性皮肤传递的反应性。这些结果得出的结论是，ISMS被参数化以增强运动输出，导致脊髓伤害性信息传递的总体净减少。这些结果表明，ISMS可能具有神经病理性疼痛相关应用的翻译潜力，并且它可能是唯一适合于为脊髓损伤患者提供多模式治疗益处的药物。
Spinal cord injury (SCI) often results in debilitating movement impairments and neuropathic pain. Electrical stimulation of spinal neurons holds considerable promise both for enhancing neural transmission in weakened motor pathways and for reducing neural transmission in overactive nociceptive pathways. However, spinal stimulation paradigms currently under development for individuals living with SCI continue overwhelmingly to be developed in the context of motor rehabilitation alone. The objective of this study is to test the hypothesis that motor-targeted spinal stimulation simultaneously modulates spinal nociceptive transmission. We characterized the neuromodulatory actions of motor-targeted intraspinal microstimulation (ISMS) on the firing dynamics of large populations of discrete nociceptive specific and wide dynamic range neurons. Neurons were accessed via dense microelectrode arrays implanted in vivo into lumbar enlargement of rats. Nociceptive and non-nociceptive cutaneous transmission was induced before, during, and after ISMS by mechanically probing the L5 dermatome. Our primary findings are that (1) sub-motor threshold ISMS delivered to spinal motor pools immediately modulates concurrent nociceptive transmission; (2) the magnitude of anti-nociceptive effects increases with longer durations of ISMS, including robust carryover effects; (3) the majority of all identified nociceptive-specific and wide dynamic range neurons exhibit firing rate reductions after only 10 min of ISMS; and (4) ISMS does not increase spinal responsiveness to non-nociceptive cutaneous transmission. These results lead to the conclusion that ISMS parameterized to enhance motor output results in an overall net decrease in spinal nociceptive transmission. These results suggest that ISMS may hold translational potential for neuropathic pain-related applications and that it may be uniquely suited to delivering multi-modal therapeutic benefits for individuals living with SCI.
登录
查看更多内容
影响因子：
5.3
作者：
Bandres, Maria F.;Gomes, Jefferson;McPherson, Jacob G.
通讯作者：
McPherson, Jacob G.
脊髓刺激必须保留本体感受，以使脊髓损伤的人类运动。
影响因子：
25
作者：
Formento E;Minassian K;Wagner F;Mignardot JB;Le Goff-Mignardot CG;Rowald A;Bloch J;Micera S;Capogrosso M;Courtine G
通讯作者：
Courtine G
影响因子：
4
作者：
Kasten MR;Sunshine MD;Secrist ES;Horner PJ;Moritz CT
通讯作者：
Moritz CT
影响因子：
14
作者：
Bamford, Jeremy A.;Todd, Kathryn G.;Mushahwar, Vivian K.
通讯作者：
Mushahwar, Vivian K.
影响因子：
2.5
作者：
Crosby, Nathan D.;Janik, John J.;Grill, Warren M.
通讯作者：
Grill, Warren M.