Review Article
Volume 13 Issue 2 - 2021
Mechanisms, Actions and New Paradigms: Spinal Cord Stimulation for Pain Management
Amit Kumar Tomar1*, Pritam Majumdar1*, Shankar Balakrishnan2 and Aslihan Cevik3
1Department of Pain and Neuromodulation, Institute of Brain and Spine Hospitals, India
2Department of Neurology, MIOT International Hospital, India
3Department of Neurosurgery, Istanbul Aydin University, Istanbul Medical Park Florya, Turkey
*Corresponding Author: Amit Kumar Tomar and Pritam Majumdar, Department of Pain and Neuromodulation, Institute of Brain and Spine Hospitals, India.
Received: January 03, 2021; Published: January 30, 2021



Abstract

Ever since the discovery of Spinal cord stimulation (SCS) in the late 1960s, it has been widely used as a treatment option for chronic neuropathic pain management. SCS has succeeded clinically in a subset of managing chronic neuropathic pain syndromic conditions. It has several limitations as well such as insufficient pain relief or control, uncomfortable sensation called paresthesia etc. These limitations pushed the conventional methods to the need of developing new targets or paradigms for Spinal Cord Stimulation like the dorsal root ganglion stimulation, burst waveform stimulation and high frequency Spinal cord Stimulation. The aim of this review is to provide a brief and concrete detail on the mechanisms and actions of SCS.

Keywords: SCS (Spinal Cord Stimulation), DRG (Dorsal Root Ganglion), HF Stimulation (High Frequency Stimulation)

References

  1. Huygen F., et al. “Evidence-based nterventional pain medicine according to clinical diagnoses: update 2018”. Pain Practic 6 (2019): 664-675.
  2. Shealy CN., et al. “Electrical inhibition of pain bystimulation of the dorsal columns: preliminary clinical report”. Anesthesia and Analgesia 4 (1967): 489-491.
  3. Melzack R and Wall PD. “Pain mechanisms: a new theory”. Science3699 (1965): 971-979.
  4. Linderoth B., et al. “Gamma-aminobutyricacid is released in the dorsal horn by electrical spinal cord stimulation:an in vivo microdialysis study in the rat”. Neurosurgery3 (1994): 484-489.
  5. Janssen S., et al. “Decreased intracellular GABAlevels contribute to spinal cord stimulation-induced analgesia in ratssuffering from painful peripheral neuropathy: the role of KCC2 andGABAA receptor-mediated inhibition”. Neurochemistry International 1 (2012): 21-30.
  6. Cui JG., et al. “Spinal cord stimulation attenuatesaugmented dorsal horn release of excitatory amino acids in mononeuropathyviaa GABAergic mechanism”. Pain1 (1997): 87-95.
  7. Saadé NE., et al. “The role of the dorsolateral funiculi in the pain relieving effect of spinal cord stimulation: a study in a rat model of neuropathic pain”. Experimental Brain Research 4 (2015): 1041-1052.
  8. Lind G., et al. “Intrathecal baclofen as adjuvant therapy to enhance the effect of spinal cord stimulation in neuropathic pain: a pilot study”. European Journal of Pain 4 (2004): 377-383.
  9. Saadé NE., et al. “Inhibition of nociceptive evoked activity in spinal neurons through a dorsal column-brainstem-spinal loop”. Brain Research 1 (1985): 115-118.
  10. Stančák A., et al. “Functional magnetic resonance imaging of cerebral activation during spinal cord stimulation in failed back surgery syndrome patients”. European Journal of Pain 2 (2008): 137-148.
  11. Ossipov MH., et al. “Central modulation of pain”. Journal of Clinical Investigation 11 (2010): 3779-3787.
  12. Song Z., et al. “The rostroventromedial medulla is engaged in the effects of spinal cord stimulation in a rodent model of neuropathic pain”. Neuroscience 247 (2013): 134-144.
  13. Song Z., et al. “Pain relief by spinal cord stimulation involves serotonergic mechanisms: an experimental study in a rat model of mononeuropathy”. Pain 1-3 (2009): 241-248.
  14. Tazawa T., et al. “Spinal cord stimulation modulates supraspinal centers of the descending antinociceptive system in rats with unilateral spinal nerve injury”. Molecular Pain 11 (2015): 36.
  15. Prabhala T., et al. “Duloxetine improves spinal cord stimulation outcomes for chronic pain”. Neuromodulation2 (2019): 215-218.
  16. Smits H., et al. “Experimental spinal cord stimulation and neuropathic pain: mechanism of action, technical aspects, and effectiveness”. Pain Practice 2 (2013): 154-168.
  17. Taylor RS., et al. “Predictors of pain relief following spinal cord stimulation in chronic back and leg pain and failed back surgery syndrome: a systematic review and meta-regression analysis”. Pain Practice 6 (2014): 489-505.
  18. Kemler MA., et al. “Effect of spinal cord stimulation for chronic complex regional pain syndrome Type I: five-year final follow-up of patients in a randomized controlled trial”. Journal of Neurosurgery 2 (2008): 292-298.
  19. Sapunar D., et al. “Dorsal root ganglion - a potential new therapeutic target for neuropathic pain”. Journal of Pain Research 5 (2012): 31-38.
  20. Krames ES. “The dorsal root ganglion in chronic pain and as a target for neuromodulation: a review”. Neuromodulation 1 (2015): 24-32.
  21. Deer TR., et al. “Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial”. Pain 4 (2017): 669-681.
  22. Liem L., et al. “One-year outcomes of spinal cord stimulation of the dorsal root ganglion in the treatment of chronic neuropathic pain”. Neuromodulation 1 (2015): 41-48.
  23. Koetsier E., et al. “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”. CNS Neuroscience and Therapeutics 1 (2020): 136-143.
  24. Du X., et al. “Local GABAergic signaling within sensory ganglia controls peripheral nociceptive transmission”. Journal of Clinical Investigation 5 (2017): 1741-1756.
  25. Pawela CP., et al. “Dorsal root ganglion stimulation attenuates the BOLD signal response to noxious sensory input in specific brain regions: insights into a possible mechanism for analgesia”. Neuroimage 147 (2017): 10-18.
  26. Koopmeiners AS., et al. “Effect of electrical field stimulation on dorsal root ganglion neuronal function”. Neuromodulation4 (2013): 304-311.
  27. Miller JP., et al. “Parameters of spinal cord stimulation and their role in electrical charge delivery: a review”. Neuromodulation 4 (2016): 373-384.
  28. Kent AR., et al. “Burst and high-frequency spinal cord stimulation differentially effect spinal neuronal activity after radiculopathy”. Annals of Biomedical Engineering 1 (2020): 112-120.
  29. Gu JW and Joosten EAJ. “Clarifying the scientific knowledge pertaining to burst waveforms in spinal cord stimulation”. Neuromodulation 6 (2019): 758-759.
  30. Ahmed S., et al. “Burst and high frequency stimulation: underlying mechanism of action”. Expert Review of Medical Devices 1 (2018): 61-70.
  31. De Ridder D., et al. “Burst spinal cord stimulation: toward paresthesia-free pain suppression”. Neurosurgery 5 (2010): 986-990.
  32. Crosby ND., et al. “Stimulation parameters define the effectiveness of burst spinal cord stimulation in a rat model of neuropathic pain”. Neuromodulation 1 (2015): 1-8.
  33. Meuwissen KPV., et al. “Burst and tonic spinal cord stimulation both activate spinal GABAergic mechanisms to attenuate pain in a rat model of chronic neuropathic pain”. Pain Practice 1 (2020): 75-87.
  34. Meuwissen KPV., et al. “Burst spinal cord stimulation in peripherally injured chronic neuropathic rats: a delayed effect”. Pain Practice 8 (2018): 988-996.
  35. De Ridder D and Vanneste S. “Burst and tonic spinal cord stimulation: different and common brain mechanisms”. Neuromodulation1 (2016): 47-59.
  36. Yearwood T., et al. “Comparison of neural activity in chronic pain patients during tonic and burst spinal cord stimulation using fluorodeoxyglucose positron emission tomography”. Neuromodulation 1 (2020): 56-63.
  37. Meuwissen KPV., et al. “Active recharge burst and tonic spinal cord stimulation engage different supraspinal mechanisms: a functional magnetic resonance imaging study in peripherally injured chronic neuropathic rats”. Pain Practice (2020).
  38. Parker JL., et al. “Compound action potentials recorded in the human spinal cord during neurostimulation for pain relief”. Pain 3 (2012): 593-601.
  39. Russo M., et al. “Effective relief of pain and associated symptoms with closed-loop spinal cord stimulation system: preliminary results of the avalon study”. Neuromodulation 1 (2018): 38-47.
  40. Russo M., et al. “Sustained long-term outcomes with closed-loop spinal cord stimulation: 12-month results of the prospective, multicenter, open-label avalon study”. Neurosurgery (2020).
  41. Mekhail N., et al. “Long-term safety and efficacy of closed-loop spinal cord stimulation to treat chronic back and leg pain (Evoke): a double-blind, randomised, controlled trial”. The Lancet Neurology 2 (2020): 123-134.
  42. Meuwissen KPV., et al. “Burst and tonic spinal cord stimulation in the mechanical conflict-avoidance system: cognitive-motivational aspects”. Neuromodulation5 (2019): 605-612.
Citation: Amit Kumar Tomar and Pritam Majumdar., et al. “Mechanisms, Actions and New Paradigms: Spinal Cord Stimulation for Pain Management”. EC Neurology 13.2 (2021): 54-60.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events

April Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the April issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before May 04, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk