Effects of spinal cord stimulation on touch-evoked allodynia involve GABAergic mechanisms. An experimental study in the mononeuropathic rat

&NA; There is much evidence that tactile allodynia in rat models of mononeuropathy produced by sciatic nerve constriction is linked to disturbance of spinal GABAergic functions. Spinal cord stimulation (SCS) applied to such animals via chronically implanted electrodes may in some of the animals induce a significant increase of the withdrawal threshold in response to innocuous mechanical stimulation with von Frey filaments applied to the paw of the nerve ligated leg. The present study was performed in mononeuropathic animals with definite signs of tactile allodynia, which did Symbol respond to SCS. GABA and the GABAB‐agonist baclofen were administered intrathecally, in doses per se insufficient to influence the withdrawal thresholds, together with the previously ineffective SCS. This combination resulted in a marked and long‐lasting increase of the thresholds. The GABAA‐agonist muscimol given together with SCS also produced a similar, but less prominent threshold increase. The GABAB‐antagonist 5‐aminovaleric acid (5‐AVA) produced a transient suppression of the threshold increase induced by SCS together with either GABA or baclofen. In contrast, the GABAA‐antagonist bicuculline had no apparent inhibitory effect on the threshold augmentation produced by SCS combined with GABA or baclofen. It is concluded that SCS may operate by upgrading the spinal GABAergic systems and that its potential for producing pain relief is dependent upon the availability of responsive GABA‐containing inhibitory interneurons. Moreover, it seems that the effects of SCS are more linked to the GABAB‐ than to the GABAA‐receptor system. Symbol. No caption available.

[1]  J. Siegfried Therapeutical neurostimulation--indications reconsidered. , 1991, Acta neurochirurgica. Supplementum.

[2]  B. Meyerson,et al.  Peripheral vasodilatation after spinal cord stimulation: animal studies of putative effector mechanisms. , 1991, Neurosurgery.

[3]  N. Bowery,et al.  Possible therapeutic application of GABAB receptor agonists and antagonists. , 1995, Clinical neuropharmacology.

[4]  A. Duggan,et al.  Bicuculline and spinal inhibition produced by dorsal column stimulation in the cat , 1985, Pain.

[5]  Z. Wiesenfeld‐Hallin,et al.  Baclofen reverses the hypersensitivity of dorsal horn wide dynamic range neurons to mechanical stimulation after transient spinal cord ischemia; implications for a tonic GABAergic inhibitory control of myelinated fiber input. , 1992, Journal of neurophysiology.

[6]  A. Light,et al.  Synaptic interactions between GABA-immunoreactive profiles and the terminals of functionally defined myelinated nociceptors in the monkey and cat spinal cord , 1992, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[7]  N. Bowery,et al.  GABAA and GABAB receptor site distribution in the rat central nervous system , 1987, Neuroscience.

[8]  U. Lindblom,et al.  Influence on touch, vibration and cutaneous pain of dorsal column stimulation in man , 1975, PAIN.

[9]  B. Meyerson,et al.  Spinal cord stimulation in animal models of mononeuropathy: effects on the withdrawal response and the flexor reflex , 1995, Pain.

[10]  K. Takakura,et al.  A new approach to the control of central deafferentation pain--spinal intrathecal baclofen. , 1995, Acta neurochirurgica. Supplement.

[11]  N. Bowery,et al.  The location of GABAB receptor binding sites in mammalian spinal cord , 1987, Synapse.

[12]  W. Willis,et al.  GABA‐immunoreactive terminals synapse on primate spinothalamic tract cells , 1992, The Journal of comparative neurology.

[13]  T. Tölle,et al.  Increase in GABAergic Cells and GABA Levels in the Spinal Cord in Unilateral Inflammation of the Hindlimb in the Rat , 1992, The European journal of neuroscience.

[14]  S. Carlton,et al.  GABAergic vesicle-containing dendrites and spines: A critical element in processing sensory input in the monkey dorsal horn , 1991, Neuroscience Letters.

[15]  B. Komisaruk,et al.  Nociceptive responses to altered GABAergic activity at the spinal cord. , 1986, Life sciences.

[16]  G. Wilkin,et al.  Are baclofen-sensitive GABAB receptors present on primary afferent terminals of the spinal cord? , 1984, Nature.

[17]  T. Yaksh Behavioral and autonomic correlates of the tactile evoked allodynia produced by spinal glycine inhibition: effects of modulatory receptor systems and excitatory amino acid antagonists , 1989, Pain.

[18]  T. Yaksh,et al.  Spinal administration of receptor-selective drugs as analgesics: new horizons. , 1990, Journal of pain and symptom management.

[19]  B. Meyerson,et al.  Dorsal column stimulation: modulation of somatosensory and autonomic function , 1995 .

[20]  S. D'Luzansky,et al.  Intrathecal baclofen suppresses central pain in patients with spinal lesions. A pilot study. , 1992, The Clinical journal of pain.

[21]  M. Geffard,et al.  Anatomical distribution and ultrastructural organization of the gabaergic system in the rat spinal cord. An immunocytochemical study using anti-GABA antibodies , 1987, Neuroscience.

[22]  G. Barolat Current Status of Epidural Spinal Cord Stimulation , 1995 .

[23]  L. Sivilotti,et al.  GABA receptor mechanisms in the central nervous system , 1991, Progress in Neurobiology.

[24]  Gary J. Bennett,et al.  A peripheral mononeuropathy in rat that produces disorders of pain sensation like those seen in man , 1988, Pain.

[25]  J. McKenzie,et al.  GABA-immunoreactive neurons in the dorsal horn of the rat spinal cord , 1989, Neuroscience.

[26]  Y. Shir,et al.  Sympathetically-maintained Causalgiform Disorders in a Model for Neuropathic Pain: A Review , 1991, Journal of basic and clinical physiology and pharmacology.

[27]  A. Cross,et al.  Effects of the putative antagonists phaclofen and δ‐aminovaleric acid on GABAB receptor biochemistry , 1989, British journal of pharmacology.

[28]  I. Tavares,et al.  GABA decreases in the spinal cord dorsal horn after peripheral neurectomy , 1993, Brain Research.

[29]  G. Volsi,et al.  Glutamate immunocytochemistry in the dorsal horn after injury or stimulation of the sciatic nerve of rats , 1993, Brain Research Bulletin.

[30]  W. Korevaar The Management of Pain, 2nd ed. , 1991 .

[31]  B. Komisaruk,et al.  Hyperalgesia induced by altered glycinergic activity at the spinal cord. , 1985, Life sciences.

[32]  A. Dickenson,et al.  Effects of topical baclofen on C fibre-evoked neuronal activity in the rat dorsal horn , 1985, Neuroscience.

[33]  Z. Wiesenfeld‐Hallin,et al.  Variability in the occurrence of ongoing discharges in primary afferents originating in the neuroma after peripheral nerve section in different strains of rats , 1994, Neuroscience Letters.

[34]  R. Nicoll,et al.  A physiological role for GABAB receptors in the central nervous system , 1988, Nature.

[35]  Ronald Dubner,et al.  A novel behavioral model of neuropathic pain disorders produced in rats by partial sciatic nerve injury , 1990, Pain.

[36]  G. Bennett,et al.  An electrophysiological study of dorsal horn neurons in the spinal cord of rats with an experimental peripheral neuropathy. , 1993, Journal of neurophysiology.

[37]  G. Johnston GABA Receptor Pharmacology , 1995 .

[38]  R. Pawl Spinal cord stimulation. , 2020, The Clinical journal of pain.

[39]  J. Sawynok GABAergic mechanisms of analgesia: An update , 1987, Pharmacology Biochemistry and Behavior.

[40]  U. Ungerstedt,et al.  Gamma-aminobutyric acid is released in the dorsal horn by electrical spinal cord stimulation: an in vivo microdialysis study in the rat. , 1994, Neurosurgery.

[41]  Xiao-jun Xu,et al.  Intrathecal γ-aminobutyric acidB (GABAB) receptor antagonist CGP 35348 induces hypersensitivity to mechanical stimuli in the rat , 1994, Neuroscience Letters.

[42]  M. Devor,et al.  Heritability of symptoms in an experimental model of neuropathic pain , 1990, Pain.

[43]  Z. Wiesenfeld‐Hallin,et al.  Decreased GABA immunoreactivity in spinal cord dorsal horn neurons after transient spinal cord ischemia in the rat , 1994, Brain Research.

[44]  C. Woolf,et al.  The contribution of GABAA and glycine receptors to central sensitization: disinhibition and touch-evoked allodynia in the spinal cord. , 1994, Journal of neurophysiology.

[45]  S. Carlton,et al.  Light microscopic and ultrastructural analysis of GABA‐immunoreactive profiles in the monkey spinal cord , 1990, The Journal of comparative neurology.

[46]  W T O'Connor,et al.  An animal model for the study of brain transmittor release in response to spinal cord stimulation in the awake, freely moving rat: preliminary results from the periaqueductal grey matter. , 1993, Acta neurochirurgica. Supplementum.

[47]  J. Kelly,et al.  Reduction in GAD I activity from the dorsal lateral region of the deafferented rat spinal cord , 1973 .

[48]  N. Bowery GABAB receptor pharmacology. , 1993, Annual review of pharmacology and toxicology.

[49]  T. Yaksh,et al.  Quantitative assessment of tactile allodynia in the rat paw , 1994, Journal of Neuroscience Methods.