51. Mechanism of dorsal root ganglion stimulation for pain relief in painful diabetic polyneuropathy is not dependent on GABA release in the dorsal horn of the spinal cord
- Author
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Lonne Heijmans, Elbert A.J. Joosten, Sander M. J. van Kuijk, Paolo Maino, Glenn Franken, Bengt Linderoth, Jacques Debets, Eva Koetsier, Anesthesiologie, RS: MHeNs - R3 - Neuroscience, Farmacologie en Toxicologie, MUMC+: KIO Kemta (9), Epidemiologie, RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: MA Anesthesiologie (9), and RS: Carim - B07 The vulnerable plaque: makers and markers
- Subjects
0301 basic medicine ,TACTILE ALLODYNIA ,Stimulation ,Rats, Sprague-Dawley ,0302 clinical medicine ,Dorsal root ganglion ,Diabetic Neuropathies ,Diabetic polyneuropathy ,Ganglia, Spinal ,Medicine ,Pharmacology (medical) ,PDPN ,health care economics and organizations ,Pain Measurement ,NEUROPATHIC PAIN ,Electrodes, Implanted ,PREVALENCE ,Psychiatry and Mental health ,medicine.anatomical_structure ,Nociception ,Hyperalgesia ,Anesthesia ,dorsal root ganglion stimulation ,INTRATHECAL BACLOFEN ,Immunohistochemistry ,Original Article ,Female ,Spinal Cord Dorsal Horn ,PERIPHERAL-NERVE INJURY ,Pain ,Electric Stimulation Therapy ,gamma-aminobutyric acid ,03 medical and health sciences ,TOUCH-EVOKED ALLODYNIA ,Physiology (medical) ,Animals ,Pain Management ,FIELD STIMULATION ,INDUCED ANALGESIA ,GAMMA-AMINOBUTYRIC-ACID ,Pharmacology ,dorsal horn ,business.industry ,Horn (anatomy) ,animal model ,spinal cord ,Original Articles ,Spinal cord ,painful diabetic polyneuropathy ,rats ,GABAERGIC INHIBITION ,030104 developmental biology ,nervous system ,γ‐aminobutyric acid ,business ,030217 neurology & neurosurgery - Abstract
Aims It is hypothesized that dorsal root ganglion stimulation (DRGS), sharing some of the mechanisms of traditional spinal cord stimulation (SCS) of the dorsal columns, induces gamma-aminobutyric acid (GABA) release from interneurons in the spinal dorsal horn. Methods We used quantitative immunohistochemical analysis in order to investigate the effect of DRGS on intensity of intracellular GABA-staining levels in the L4-L6 spinal dorsal horn of painful diabetic polyneuropathy (PDPN) animals. To establish the maximal pain relieving effect, we tested for mechanical hypersensitivity to von Frey filaments and animals received 30 minutes of DRGS at day 3 after implantation of the electrode. One day later, 4 Sham-DRGS animals and four responders-to-DRGS received again 30 minutes of DRGS and were perfused at the peak of DRGS-induced pain relief. Results No significant difference in GABA-immunoreactivity was observed between DRGS and Sham-DRGS in lamina 1-3 of the spinal levels L4-6 neither ipsilaterally nor contralaterally. Conclusions Dorsal root ganglion stimulation does not induce GABA release from the spinal dorsal horn cells, suggesting that the mechanisms underlying DRGS in pain relief are different from those of conventional SCS. The modulation of a GABA-mediated "Gate Control" in the DRG itself, functioning as a prime Gate of nociception, is suggested and discussed.
- Published
- 2020