Dorsal root ganglion stimulation for chronic pain modulates Aβ-fiber activity but not C-fiber activity: A computational modeling study

Robert D Graham; Tim M Bruns; Bo Duan; Scott F Lempka

doi:10.1016/j.clinph.2019.02.016

Dorsal root ganglion stimulation for chronic pain modulates Aβ-fiber activity but not C-fiber activity: A computational modeling study

Clin Neurophysiol. 2019 Jun;130(6):941-951. doi: 10.1016/j.clinph.2019.02.016. Epub 2019 Mar 15.

Authors

Robert D Graham¹, Tim M Bruns¹, Bo Duan², Scott F Lempka³

Affiliations

¹ Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA.
² Department of Molecular, Cellular, and Developmental Biology, University of Michigan, Ann Arbor, MI, USA.
³ Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA; Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA. Electronic address: lempka@umich.edu.

Abstract

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 Aβ-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.

Keywords: Chronic pain; Computer simulation; Dorsal root ganglion; Electric stimulation; Spinal cord stimulation.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Chronic Pain / physiopathology
Chronic Pain / therapy*
Ganglia, Spinal / physiology*
Humans
Models, Biological*
Nerve Fibers, Myelinated / physiology*
Nerve Fibers, Unmyelinated / physiology*
Spinal Cord Stimulation / methods*

Abstract

Publication types

MeSH terms

Grants and funding