Dorsal root ganglion stimulation for chronic pain modulates Aβ-fiber activity but not C-fiber activity: A computational modeling study
Dorsal root ganglion stimulation for chronic pain modulates Aβ-fiber activity but not C-fiber activity: A computational modeling study
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DOI：
10.1016/j.clinph.2019.02.016
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发表时间：
2019-06-01
影响因子：
4.7
通讯作者：
Lempka, Scott F.
中科院分区：
文献类型：
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作者：
Graham, Robert D.;Bruns, Tim M.;Lempka, Scott F.
目的：该项目的目标是使用计算模型来研究哪些类型的初级感觉神经元受到背根神经节刺激 (DRGS) 的调节以缓解疼痛。方法：我们通过将人类 L5 背根神经节的解剖有限元模型与初级感觉神经元的生物物理模型耦合来建模 DRGS。我们计算了在每个神经元中引发动作电位所需的刺激幅度，并检查了 DRGS 如何影响感觉神经元活动。结果：我们表明，在刺激参数的临床范围内，DRGS 驱动大有髓鞘 A β 纤维的活动，但不直接激活小的无髓鞘 C 纤维。我们还表明，主动电极和返回电极的位置以及刺激脉冲的极性会影响神经激活。结论：我们的结果表明，DRGS 可以通过重复激活大髓鞘传入神经来激活背角中的疼痛门控机制，从而提供疼痛缓解。意义：了解 DRGS 诱导的疼痛缓解的作用机制可能会导致刺激技术的创新，从而改善患者的治疗效果。 (C) 2019 年国际临床神经生理学联合会。由 Elsevier B.V. 出版。保留所有权利。
Objective: The goal of this project was to use computational models to investigate which types of primary sensory neurons are modulated by dorsal root ganglion stimulation (DRGS) to provide pain relief.Methods: We modeled DRGS by coupling an anatomical finite element model of a human L5 dorsal root ganglion to biophysical models of primary sensory neurons. We calculated the stimulation amplitude needed to elicit an action potential in each neuron, and examined how DRGS affected sensory neuron activity.Results: We showed that within clinical ranges of stimulation parameters, DRGS drives the activity of large myelinated A beta-fibers but does not directly activate small nonmyelinated C-fibers. We also showed that the position of the active and return electrodes and the polarity of the stimulus pulse influence neural activation.Conclusions: Our results indicate that DRGS may provide pain relief by activating pain-gating mechanisms in the dorsal horn via repeated activation of large myelinated afferents.Significance: Understanding the mechanisms of action of DRGS-induced pain relief may lead to innovations in stimulation technologies that improve patient outcomes. (C) 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.