利用诱发复合动作电位定量测定绵羊脊髓脉冲和常规40赫兹刺激下的差异神经激活。

IF 3.4 Q2 NEUROSCIENCES
Pain Reports Pub Date : 2022-11-11 eCollection Date: 2022-11-01 DOI:10.1097/PR9.0000000000001047
David A Dinsmoor, Joshua O Usoro, Noah D Barka, Tina M Billstrom, Leonid M Litvak, Lawrence R Poree
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引用次数: 0

摘要

与传统的脊髓背刺激(SCS)不同,它使用固定速率的单脉冲,burst SCS使用固定速率的五脉冲刺激簇作为慢性疼痛的治疗;机制解释表明,与常规SCS相比,破裂SCS对内侧和外侧疼痛通路的调节是不同的。脊髓诱发复合动作电位(ECAP)是一种同步神经激活的电测量方法,可以量化突发和常规SCS之间的神经激活差异。方法:在7只羊的T9/T10处植入背侧刺激导线,在T6/T7处植入背侧ECAP感应导线,在T9/T10处植入靠近前外侧系统(ALS)的导线。将刺激幅度高达视觉运动阈值(vMT)的爆发和常规SCS传递到3个不同的脊髓背侧位置,并计算所有组合的ECAP阈值(ECAPTs)。然后,用两种类型的SCS评估ALS激活的变化。结果:常规刺激组与突发刺激组的诱发复合动作电位阈值和vmt均显著高于常规刺激组(P < 0.05),刺激部位间差异无统计学意义(P > 0.05)。然而,vMT-ECAPT窗口(可用治疗剂量范围的代理)在常规和突发SCS中明显更宽(P < 0.05)。常规SCS与破裂SCS在ALS激活方面无显著差异(P > 0.05)。结论:当剂量相等时,破裂SCS与常规SCS在ALS激活结果上没有差异。此外,亚ecapt爆发的SCS在与疼痛相关的棘上部位的神经通路中没有明显的兴奋性变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Using evoked compound action potentials to quantify differential neural activation with burst and conventional, 40 Hz spinal cord stimulation in ovines.

Using evoked compound action potentials to quantify differential neural activation with burst and conventional, 40 Hz spinal cord stimulation in ovines.

Using evoked compound action potentials to quantify differential neural activation with burst and conventional, 40 Hz spinal cord stimulation in ovines.

Using evoked compound action potentials to quantify differential neural activation with burst and conventional, 40 Hz spinal cord stimulation in ovines.

Unlike conventional dorsal spinal cord stimulation (SCS)-which uses single pulses at a fixed rate-burst SCS uses a fixed-rate, five-pulse stimuli cluster as a treatment for chronic pain; mechanistic explanations suggest burst SCS differentially modulate the medial and lateral pain pathways vs conventional SCS. Neural activation differences between burst and conventional SCS are quantifiable with the spinal-evoked compound action potential (ECAP), an electrical measure of synchronous neural activation.

Methods: We implanted 7 sheep with a dorsal stimulation lead at T9/T10, a dorsal ECAP sensing lead at T6/T7, and a lead also at T9/T10 but adjacent to the anterolateral system (ALS). Both burst and conventional SCS with stimulation amplitudes up to the visual motor threshold (vMT) were delivered to 3 different dorsal spinal locations, and ECAP thresholds (ECAPTs) were calculated for all combinations. Then, changes in ALS activation were assessed with both types of SCS.

Results: Evoked compound action potential thresholds and vMTs were significantly higher (P < 0.05) with conventional vs burst SCS, with no statistical difference (P > 0.05) among stimulation sites. However, the vMT-ECAPT window (a proxy for the useable therapeutic dosing range) was significantly wider (P < 0.05) with conventional vs burst SCS. No significant difference (P > 0.05) in ALS activation was noted between conventional and burst SCS.

Conclusion: When dosed equivalently, no differentially unique change in ALS activation results with burst SCS vs conventional SCS; in addition, sub-ECAPT burst SCS results in no discernable excitability changes in the neural pathways feeding pain relevant supraspinal sites.

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来源期刊
Pain Reports
Pain Reports Medicine-Anesthesiology and Pain Medicine
CiteScore
7.50
自引率
2.10%
发文量
93
审稿时长
8 weeks
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