Neurophysiological effects of high-frequency spinal cord stimulation on cortico-sensory areas in large ovine animal model

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2025-07-08 DOI:10.1016/j.jpain.2025.105493

Vishal Bharmauria , Hiroyuki Oya , Yarema Bezchlibnyk , Nour Shaheen , Amirhossein Ghaderi , Karim Johari , Arun Singh , Alexander L. Green , Hiroto Kawasaki , Can Sarica , Brian Dalm , Andres M. Lozano , Matthew A. Howard III , Oliver Flouty

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引用次数: 0

Abstract

Spinal Cord Stimulation (SCS) has been a cornerstone in managing chronic pain since the late 1960s. However, traditional SCS is often associated with variable efficacy and side effects, driving the development of advanced techniques like high-frequency SCS (hSCS). Previous studies have demonstrated that the power of high-frequency cerebral oscillations increases as a function of stimulus intensity and plays a critical role in local neural processing of peripheral sensory stimuli. Extending from the current body of literature, we hypothesized that hSCS could selectively influence stimulus-triggered neural oscillations involved in sensory processing and perception. Using electrocorticography (ECoG) in sheep (n = 4), we investigated the effects of 8.2 KHz hSCS on low-frequency (4–30 Hz) and high-frequency (70–150 Hz) oscillations in ovine somatosensory and association cortices. Neural signals were recorded before, and after hSCS application to assess frequency-specific modulation of cortical activity. Our findings reveal that hSCS induces broad suppression of high-frequency oscillations across both cortical regions. In contrast, low-frequency oscillations were selectively suppressed or enhanced in both cortices. Furthermore, a linear mixed model analysis revealed that low-frequency oscillations better predict high-frequency modulation in the association than the somatosensory cortex, highlighting a reciprocal low-/high-frequency relationship between cortices. These distinct effects on cortical oscillations suggest potential supraspinal mechanisms through which hSCS may exert its analgesic effects. Our findings provide new insights for optimizing neuromodulation strategies in pain management, emphasizing the role of frequency-specific modulation in sensory and cognitive pain processing.

Perspective

This study demonstrates that high-frequency spinal cord stimulation modulates cortical oscillations in a frequency- and region-specific manner, suggesting a supraspinal mechanism of pain. These findings advance our understanding of how neuromodulation influences sensory components of pain, with implications for optimizing stimulation protocols in chronic pain management.

查看原文本刊更多论文

高频脊髓刺激对大型羊动物模型皮质感觉区的神经生理影响

自20世纪60年代末以来，脊髓刺激（SCS）一直是治疗慢性疼痛的基石。然而，传统的SCS往往具有不同的疗效和副作用，这推动了高频SCS （hSCS）等先进技术的发展。以往的研究表明，大脑高频振荡的强度随着刺激强度的增加而增加，并在局部神经处理周围感觉刺激中起着关键作用。根据目前的文献，我们假设hSCS可以选择性地影响刺激触发的与感觉加工和知觉有关的神经振荡。利用羊（n = 4）的皮质电图（ECoG），我们研究了8.2 KHz hSCS对羊体感皮层和关联皮层低频（4 - 30 Hz）和高频（70-150 Hz）振荡的影响。在应用hSCS之前和之后记录神经信号，以评估皮层活动的频率特异性调节。我们的研究结果表明，hSCS诱导了两个皮质区域的高频振荡的广泛抑制。相反，低频振荡在两个皮层中被选择性地抑制或增强。此外，线性混合模型分析显示，低频振荡比体感觉皮层更能预测关联中的高频调制，突出了皮层之间的互低/高频关系。这些对皮质振荡的不同影响提示了hSCS可能通过棘上机制发挥其镇痛作用。我们的研究结果为优化疼痛管理中的神经调节策略提供了新的见解，强调了频率特异性调节在感觉和认知疼痛处理中的作用。该研究表明，高频脊髓刺激以频率和区域特异性的方式调节皮质振荡，提示疼痛的椎管上机制。这些发现促进了我们对神经调节如何影响疼痛的感觉成分的理解，对优化慢性疼痛管理的刺激方案具有启示意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.