Postsynaptic dorsal column pathway activation during spinal cord stimulation in patients with chronic pain
Spinal cord stimulation (SCS) treatment for chronic pain relies on the activation of primary sensory fibres ascending to the brain in the dorsal columns. While the efficacy of SCS has been demonstrated, the precise mechanism of action and nature of the fibres activated by stimulation remain largely...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1297814/full |
| _version_ | 1797384268277612544 |
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| author | Gerrit Eduard Gmel Rosana Santos Escapa Teddy Edmond Benkohen Dave Mugan John Louis Parker Stefano Palmisani |
| author_facet | Gerrit Eduard Gmel Rosana Santos Escapa Teddy Edmond Benkohen Dave Mugan John Louis Parker Stefano Palmisani |
| author_sort | Gerrit Eduard Gmel |
| collection | DOAJ |
| description | Spinal cord stimulation (SCS) treatment for chronic pain relies on the activation of primary sensory fibres ascending to the brain in the dorsal columns. While the efficacy of SCS has been demonstrated, the precise mechanism of action and nature of the fibres activated by stimulation remain largely unexplored. Our investigation in humans with chronic neuropathic pain undergoing SCS therapy, found that post-synaptic dorsal column (PSDC) fibres can be activated synaptically by the primary afferents recruited by stimulation, and axonically by the stimulation pulses directly. Synaptic activation occurred in 9 of the 14 patients analysed and depended on the vertebral level of stimulation. A clear difference in conduction velocities between the primary afferents and the PSDC fibres were observed. Identification of PSDC fibre activation in humans emphasises the need for further investigation into the role they play in pain relief and the sensory response sensation (paraesthesia) experienced by patients undergoing SCS. |
| first_indexed | 2024-03-08T21:33:58Z |
| format | Article |
| id | doaj.art-3daeef088dcc428eb39ea65ab2387de5 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-08T21:33:58Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-3daeef088dcc428eb39ea65ab2387de52023-12-21T04:14:00ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-12-011710.3389/fnins.2023.12978141297814Postsynaptic dorsal column pathway activation during spinal cord stimulation in patients with chronic painGerrit Eduard Gmel0Rosana Santos Escapa1Teddy Edmond Benkohen2Dave Mugan3John Louis Parker4Stefano Palmisani5Saluda Medical, Macquarie Park, NSW, AustraliaSaluda Medical, Macquarie Park, NSW, AustraliaSaluda Medical, Macquarie Park, NSW, AustraliaSaluda Medical, Macquarie Park, NSW, AustraliaSaluda Medical, Macquarie Park, NSW, AustraliaGuy’s and St. Thomas’ NHS Foundation Trust, London, United KingdomSpinal cord stimulation (SCS) treatment for chronic pain relies on the activation of primary sensory fibres ascending to the brain in the dorsal columns. While the efficacy of SCS has been demonstrated, the precise mechanism of action and nature of the fibres activated by stimulation remain largely unexplored. Our investigation in humans with chronic neuropathic pain undergoing SCS therapy, found that post-synaptic dorsal column (PSDC) fibres can be activated synaptically by the primary afferents recruited by stimulation, and axonically by the stimulation pulses directly. Synaptic activation occurred in 9 of the 14 patients analysed and depended on the vertebral level of stimulation. A clear difference in conduction velocities between the primary afferents and the PSDC fibres were observed. Identification of PSDC fibre activation in humans emphasises the need for further investigation into the role they play in pain relief and the sensory response sensation (paraesthesia) experienced by patients undergoing SCS.https://www.frontiersin.org/articles/10.3389/fnins.2023.1297814/fullspinal cord stimulationneuroanatomyelectrophysiologypostsynaptic dorsal column pathwayneuropathic painmechanism of action |
| spellingShingle | Gerrit Eduard Gmel Rosana Santos Escapa Teddy Edmond Benkohen Dave Mugan John Louis Parker Stefano Palmisani Postsynaptic dorsal column pathway activation during spinal cord stimulation in patients with chronic pain Frontiers in Neuroscience spinal cord stimulation neuroanatomy electrophysiology postsynaptic dorsal column pathway neuropathic pain mechanism of action |
| title | Postsynaptic dorsal column pathway activation during spinal cord stimulation in patients with chronic pain |
| title_full | Postsynaptic dorsal column pathway activation during spinal cord stimulation in patients with chronic pain |
| title_fullStr | Postsynaptic dorsal column pathway activation during spinal cord stimulation in patients with chronic pain |
| title_full_unstemmed | Postsynaptic dorsal column pathway activation during spinal cord stimulation in patients with chronic pain |
| title_short | Postsynaptic dorsal column pathway activation during spinal cord stimulation in patients with chronic pain |
| title_sort | postsynaptic dorsal column pathway activation during spinal cord stimulation in patients with chronic pain |
| topic | spinal cord stimulation neuroanatomy electrophysiology postsynaptic dorsal column pathway neuropathic pain mechanism of action |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1297814/full |
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