Examination of Differential Target Reduced Energy Spinal Cord Stimulation for Neuropathic Pain in an Animal Model

Spinal cord stimulation (SCS) is an effective pain management therapy used to reduce chronic, neuropathic pain for individuals whom traditional methods, particularly opioid use, have not been completely successful. SCS provides neural stimulation via an electrode array attached to the dorsal section of the spinal cord epidurally. The electrode emits an oscillating electric field that disrupts the action potential of neuronal signals, decreasing pain responses. A wide variety of stimulation parameters have been studied in an attempt to find the ideal frequency for clinical treatment. However, many of these methods have a high rate of energy use, which can affect battery life and lead to less compliance with the ideal treatment regimen. Differential target multiplexed programming (DTMP) seeks to overcome this barrier by providing electrical stimulation at timed intervals. If proven as effective as traditional methods, this method would result in much more practical implementation of SCS for daily use. For this study, Sprague-Dawley rats were used for the animal model due to the physiological similarities to the human nervous system. Male, adult rats received a spared nerve injury (SNI) to the sciatic nerve which is a well-established rat model of chronic pain. The rats were then randomly assigned to one of the five following groups: Naïve, No-SCS, DTRE1-SCS, DTRE2-SCS, or Low-Rate (LR)-SCS. DTRE1-SCS provided a 15 minute on/15 minute off stimulation pattern while DTRE2-SCS provided a 15 minute on/30 minute off stimulation pattern, and LR-SCS provided continuous stimulation. The animal\u27s pain threshold was observed prior and post intervention examining the paw withdrawal thresholds (PWT) with Von Frey filaments. Results found that both reduced energy conditions (DTRE1-SCS, DTRE2-SCS groups) significantly decreased pain responses compared to the Naive and No-SCS groups and the more traditional LS-SCS approach, and thus, should be considered for potential human use