Dataset Information

A new dual function dorsal root ganglion stimulation in pain management: a technical note and case report.

ABSTRACT: Sensitization of dorsal horn ganglion sensory neuron plays a crucial role in the maintenance of chronic pain disorder. Multiple interventions targeting dorsal horn ganglion can provide considerable relief of pain, including selective nerve root block, pulsed radiofrequency, and electrical nerve stimulation technique. It remains controversial about the superiority of neuromodulation mentioned above due to distinct pattern of analgesic mechanism. Here, we reported one 71-year-old male presenting at our pain clinic with severe, unilateral lower limb pain caused by postherpetic neuralgia. An implantable stimulator with dual neuromodulation mode, combining pulsed radiofrequency with electrical nerve stimulation, was then placed into the lateral epidural space adjacent to dorsal root ganglion at L4 level. Standard stimulation programing was performed with technicians to achieve satisfactory control of pain, with numerical rating scale decreasing from 8 to 2 postoperatively. This novel dual function neuromodulation strategy may provide an alternative option for pain management for those with intractable neuropathic pain.

SUBMITTER: Wang Q

PROVIDER: S-EPMC10580718 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A new dual function dorsal root ganglion stimulation in pain management: a technical note and case report.

Wang Qiao Q Han Rui R Hu Rong R Liu Qianxi Q Huang Dong D Zhou Haocheng H

Therapeutic advances in chronic disease 20231017

Sensitization of dorsal horn ganglion sensory neuron plays a crucial role in the maintenance of chronic pain disorder. Multiple interventions targeting dorsal horn ganglion can provide considerable relief of pain, including selective nerve root block, pulsed radiofrequency, and electrical nerve stimulation technique. It remains controversial about the superiority of neuromodulation mentioned above due to distinct pattern of analgesic mechanism. Here, we reported one 71-year-old male presenting a ...[more]

PMID: 37854457

Similar Datasets

Project description:BackgroundDorsal root ganglion field stimulation is an analgesic neuromodulation approach in use clinically, but its mechanism is unknown as there is no validated animal model for this purpose. The authors hypothesized that ganglion stimulation is effective in reducing pain-like behaviors in preclinical chronic pain models.MethodsThe authors provided ganglion stimulation or spinal cord stimulation to rats with traumatic neuropathy (tibial nerve injury), or osteoarthritis induced by intraarticular knee monosodium iodoacetate, or without injury (naïve). Analgesia was evaluated by testing a battery of pain-related reflexive, functional, and affective behaviors.ResultsIn rats with nerve injury, multilevel L4 and L5 ganglion stimulation decreased hypersensitivity to noxious mechanical stimulation more (area under curve, -1,447 ± 423 min × % response; n = 12) than single level ganglion stimulation at L4 ([-960 ± 251 min × % response; n = 8; P = 0.012] vs. L4 and L5), and L5 ([-676 ± 295 min × % response; n = 8; P < 0.0001] vs. L4 and L5). Spontaneous pain-like behavior, evaluated by conditioned place preference, responded to single L4 (Pretest [-93 ± 65 s] vs. Test [87 ± 82 s]; P = 0.002; n = 9), L5 (Pretest [-57 ± 36 s] vs. Test [137 ± 73 s]; P = 0.001; n = 8), and multilevel L4 and L5 (Pretest: -81 ± 68 s vs. Test: 90 ± 76 s; P = 0.003; n = 8) ganglion stimulation. In rats with osteoarthritis, multilevel L3 and L4 ganglion stimulation reduced sensitivity to knee motion more (-156 ± 28 min × points; n = 8) than L3 ([-94 ± 19 min × points in knee bend test; n = 7; P = 0.002] vs. L3 and L4) or L4 ([-71 ± 22 min × points; n = 7; P < 0.0001] vs. L3 and L4). Conditioned place preference during osteoarthritis revealed analgesic effectiveness for ganglion stimulation when delivered at L3 (Pretest [-78 ± 77 s] vs. Test [68 ± 136 s]; P = 0.048; n = 9), L4 (Pretest [-96 ± 51 s] vs. Test [73 ± 111 s]; P = 0.004; n = 9), and L3 and L4 (Pretest [-69 ± 52 s; n = 7] vs. Test [55 ± 140 s]; P = 0.022; n = 7).ConclusionsDorsal root ganglion stimulation is effective in neuropathic and osteoarthritic preclinical rat pain models with peripheral pathologic origins, demonstrating effectiveness of ganglion stimulation in a placebo-free setting and justifying this model as a suitable platform for mechanistic studies.

Project description:Introduction: Sympathetic hyperactivity is strongly associated with ventricular arrhythmias and sudden cardiac death. Neuromodulation provides therapeutic options for ventricular arrhythmias by modulating cardiospinal reflexes and reducing sympathetic output at the level of the spinal cord. Dorsal root ganglion stimulation (DRGS) is a recent neuromodulatory approach; however, its role in reducing ventricular arrhythmias has not been evaluated. The aim of this study was to determine if DRGS can reduce cardiac sympathoexcitation and the indices for ventricular arrhythmogenicity induced by programmed ventricular extrastimulation. We evaluated the efficacy of thoracic DRGS at both low (20 Hz) and high (1 kHz) stimulation frequencies. Methods: Cardiac sympathoexcitation was induced in Yorkshire pigs (n = 8) with ventricular extrastimulation (S1/S2 pacing), before and after DRGS. A DRG-stimulating catheter was placed at the left T2 spinal level, and animals were randomized to receive low-frequency (20 Hz and 0.4 ms) or high-frequency (1 kHz and 0.03 ms) DRGS for 30 min. High-fidelity cardiac electrophysiological recordings were performed with an epicardial electrode array measuring the indices of ventricular arrhythmogenicity-activation recovery intervals (ARIs), electrical restitution curve (Smax), and Tpeak-Tend interval (Tp-Te interval). Results: Dorsal root ganglion stimulation, at both 20 Hz and 1 kHz, decreased S1/S2 pacing-induced ARI shortening (20 Hz DRGS -21±7 ms, Control -50±9 ms, P = 0.007; 1 kHz DRGS -13 ± 2 ms, Control -46 ± 8 ms, P = 0.001). DRGS also reduced arrhythmogenicity as measured by a decrease in Smax (20 Hz DRGS 0.5 ± 0.07, Control 0.7 ± 0.04, P = 0.006; 1 kHz DRGS 0.5 ± 0.04, Control 0.7 ± 0.03, P = 0.007), and a decrease in Tp-Te interval/QTc (20 Hz DRGS 2.7 ± 0.13, Control 3.3 ± 0.12, P = 0.001; 1 kHz DRGS 2.8 ± 0.08, Control; 3.1 ± 0.03, P = 0.007). Conclusions: In a porcine model, we show that thoracic DRGS decreased cardiac sympathoexcitation and indices associated with ventricular arrhythmogenicity during programmed ventricular extrastimulation. In addition, we demonstrate that both low-frequency and high-frequency DRGS can be effective neuromodulatory approaches for reducing cardiac excitability during sympathetic hyperactivity.

Dataset Information

A new dual function dorsal root ganglion stimulation in pain management: a technical note and case report.

Publications

A new dual function dorsal root ganglion stimulation in pain management: a technical note and case report.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets