Differential Modulation of Dorsal Horn Neurons by Various Spinal Cord Stimulation Strategies

• Main Authors: Kwan Yeop Lee, Dongchul Lee, Zachary B. Kagan, Dong Wang, Kerry Bradley
• Format: Article
• Language: English
• Published: MDPI AG 2021-05-01
• Series: Biomedicines
• Subjects: spinal cord stimulation; dorsal horn neurons; high frequency; kilohertz; burst
• Online Access: https://www.mdpi.com/2227-9059/9/5/568

New strategies for spinal cord stimulation (SCS) for chronic pain have emerged in recent years, which may work better via different analgesic mechanisms than traditional low-frequency (e.g., 50 Hz) paresthesia-based SCS. To determine if 10 kHz and burst SCS waveforms might have a similar mechanistic basis, we examined whether these SCS strategies at intensities ostensibly below sensory thresholds would modulate spinal dorsal horn (DH) neuronal function in a neuron type-dependent manner. By using an in vivo electrophysiological approach in rodents, we found that low-intensity 10 kHz SCS, but not burst SCS, selectively activates inhibitory interneurons in the spinal DH. This study suggests that low-intensity 10 kHz SCS may inhibit pain-sensory processing in the spinal DH by activating inhibitory interneurons without activating DC fibers, resulting in paresthesia-free pain relief, whereas burst SCS likely operates via other mechanisms.