Sub-paresthesia spinal cord stimulation reverses thermal hyperalgesia and modulates low frequency EEG in a rat model of neuropathic pain

Sci Rep. 2018 May 8;8(1):7181. doi: 10.1038/s41598-018-25420-w.

Abstract

Paresthesia, a common feature of epidural spinal cord stimulation (SCS) for pain management, presents a challenge to the double-blind study design. Although sub-paresthesia SCS has been shown to be effective in alleviating pain, empirical criteria for sub-paresthesia SCS have not been established and its basic mechanisms of action at supraspinal levels are unknown. We tested our hypothesis that sub-paresthesia SCS attenuates behavioral signs of neuropathic pain in a rat model, and modulates pain-related theta (4-8 Hz) power of the electroencephalogram (EEG), a previously validated correlate of spontaneous pain in rodent models. Results show that sub-paresthesia SCS attenuates thermal hyperalgesia and power amplitude in the 3-4 Hz range, consistent with clinical data showing significant yet modest analgesic effects of sub-paresthesia SCS in humans. Therefore, we present evidence for anti-nociceptive effects of sub-paresthesia SCS in a rat model of neuropathic pain and further validate EEG theta power as a reliable 'biosignature' of spontaneous pain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Double-Blind Method
  • Electroencephalography
  • Humans
  • Hyperalgesia / physiopathology
  • Hyperalgesia / therapy*
  • Neuralgia / diagnostic imaging
  • Neuralgia / physiopathology
  • Neuralgia / therapy*
  • Pain Management
  • Pain Measurement
  • Paresthesia / physiopathology
  • Paresthesia / therapy
  • Rats
  • Spinal Cord / diagnostic imaging
  • Spinal Cord / physiopathology*
  • Spinal Cord Stimulation / methods*