Dorsal Root Ganglion Stimulation for Chronic Pain: Hypothesized Mechanisms of Action

JOURNAL OF PAIN

卷:23

Article

Graham, Robert D.^1,2  Sankarasubramanian, Vishwanath^1,2  Lempka, Scott F.^1,2,3 

[1] Univ Michigan, Dept Biomed Engn, 2800 Plymouth Rd,NCRC 14-184, Ann Arbor, MI 48109 USA

[2] Univ Michigan, Biointerfaces Inst, Ann Arbor, MI 48109 USA

[3] Univ Michigan, Dept Anesthesiol, Ann Arbor, MI 48109 USA

关键词: Dorsal root ganglion stimulation;    electric stimulation;    chronic pain;    neuropathic pain;    implanted neurostimulators;   

DOI  :  10.1016/j.jpain.2021.07.008

来源: Elsevier

【 摘 要 】

Dorsal root ganglion stimulation (DRGS) is a neuromodulation therapy for chronic pain that is refractory to conventional medical management. Currently, the mechanisms of action of DRGS-induced pain relief are unknown, precluding both our understanding of why DRGS fails to provide pain relief to some patients and the design of neurostimulation technologies that directly target these mechanisms to maximize pain relief in all patients. Due to the heterogeneity of sensory neurons in the dorsal root ganglion (DRG), the analgesic mechanisms could be attributed to the modulation of one or many cell types within the DRG and the numerous brain regions that process sensory information. Here, we summarize the leading hypotheses of the mechanisms of DRGS-induced analgesia, and propose areas of future study that will be vital to improving the clinical implementation of DRGS. Perspective: This article synthesizes the evidence supporting the current hypotheses of the mechanisms of action of DRGS for chronic pain and suggests avenues for future interdisciplinary research which will be critical to fully elucidate the analgesic mechanisms of the therapy.

【 授权许可】

Free