• The Korean Journal of Pain
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• v.18 no.2
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• pp.214-217
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• 2005

Spinal cord stimulation (SCS) was first attempted by Shearly et al for the relief of intractable pain. A spinal cord stimulator has traditionally been used for failed back surgery syndrome (FBSS) angina pectoris, complex regional pain syndrome (CRPS) and ischemic pain in the extremity. However, the complications associated with the use of a spinal cord stimulator, such as wound infection, hematoma, lead migration and device malfunction; make its long term application difficult. Here, our experience of an interesting case, in which intractable right leg pain was controlled using a spinal cord stimulator placed in the left epidural space, is reported, with a review of the literature.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.509-512
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• 2012

Objective : The purpose of this study is to evaluate neuroprotective effect of sacral neuromodulation in rat spinal cord injury (SCI) model in the histological and functional aspects. Methods : Twenty-one female Sprague Dawley rats were randomly divided into 3 groups : the normal control group (CTL, n=7), the SCI with sham stimulation group (SCI, n=7), and the SCI with electrical stimulation (SCI+ES, n=7). Spinal cord was injured by dropping an impactor from 25 mm height. Sacral nerve electrical stimulation was performed by the following protocol : pulse duration, 0.1 ms; frequency, 20 Hz; stimulation time, 30 minutes; and stimulation duration, 4 weeks. Both locomotor function and histological examination were evaluated as scheduled. Results : The number of anterior horn cell was $12.3{\pm}5.7$ cells/high power field (HPF) in the CTL group, $7.8{\pm}4.9$ cells/HPF in the SCI group, and $6.9{\pm}5.5$ cells/HPF in the SCI+ES group, respectively. Both the SCI and the SCI+ES groups showed severe loss of anterior horn cells and myelin fibers compared with the CTL group. Cavitation and demyelinization of the nerve fibers has no significant difference between the SCI group and the SCI+ES group. Cavitation of dorsal column was more evident in only two rats of SCI group than the SCI+ES group. The locomotor function of all rats improved over time but there was no significant difference at any point in time between the SCI and the SCI+ES group. Conclusion : In a rat thoracic spinal cord contusion model, we observed that sacral neuromodulation did not prevent SCI-induced myelin loss and apoptosis.

• The Korean Journal of Physiology
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• v.30 no.1
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• pp.85-96
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• 1996

Adenosine and its analogues are known to possess analgesic effects and to be involved in the opiate-induced antinociception as well. This study was designed to investigate the effects of three adenosine agonists, 5'- (N-cyclopropyl) -carboxamidoadenosine(CPCA), 5'-N-ethylcarboxamidoadeno-sine (NECA) and $N^6-cyclohexyladenosine$ (CHA) on the signal transmission in the spinal cord and also to elucidate mechanisms of their actions in the anesthetized cat. All the tested adenosine agonists(i.v,) exerted inhibitory effects on the responsiveness of the wide dynamic range (WDR) cells, the inhibitory action of CHA, an adenosine $A_1$ receptor agonist, $(80{\mu}g/Kg)$ being most weak. The intravenous CPCA, an adenosine $A_2$ receptor agonist, $(20{\mu}g\;/Kg)$ and NECA, nonspecific adenosine receptor agonist, $(20{\mu}g\;/Kg)$ inhibited the responses of WDR cells to pinch and C fiber stimulation more strongly than those to brush and A fiber stimulation. CPCA (i.v.) also suppressed the responses of WDR cells to thermal stimulus. And all the CPCA-induced inhibitions were caffeine-reversible. When CPCA was directly applied onto the spinal cord or intravenously administered into the spinal cat, on average, about three quarters of the CPCA-induced inhibitory effect was abolished. On the other hand, in the animal with spinal lesions in the ipsilateral dorsolateral area, the CPCA-induced inhibition was comparable to that observed in the spinal cats. In conclusion, this study shows that adenosine agonists strongly suppress the responses of WDR cells to pinch, C fiber stimulation and thermal stimuli mainly through the supraspinal adenosine $A_2-receptors$.

• The Korean Journal of Physiology
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• v.30 no.2
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• pp.289-297
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• 1996

Excitatory amino acids (EAA) are thought to play an important role in producing cell death associated with ischemic and traumatic spinal cord injury. The present study was carried out to determine if the response characteristics of spinal sensory neurons in segments adjacent to degeneration sites induced by EAA are altered following these morphological changes. Intraspinal injections of quisqualic acid (QA) produced neuronal degeneration and spinal cavitation of gray matter. The severity of lesions was significantly attenuated by pretreatment with a non-NMDA antagonist NBQX. In extracellular single unit recordings, dorsal horn neurons in QA injected animal showed the increased mechanosensitivity, which included a shift to the left in the stimulus-response relationship, an increased background activity and an increase in the duration of after-discharge responses. Neuronal responses, especially the C-fiber response, to suprathreshold electrical stimulation of sciatic nerve also increased in most cases. These results suggest that altered functional states of neurons may be responsible for sensory abnormalities, e.g. allodynia and hyperalgesia, associated with syringomyolia and spinal cord injury.

• Journal of Magnetics
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• v.20 no.4
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• pp.427-431
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• 2015

The aim of this study was to investigate whether repetitive transcranial magnetic stimulation (rTMS) can improve motor recovery in the lower extremities of the patients with subacute stage spinal cord injury (SCI). This study was conducted with 19 subjects diagnosed with paraplegia because of SCI. The experimental group included 10 subjects who underwent active rTMS, and the control group included 9 subjects who underwent sham rTMS. The SCI patients in the experimental group underwent conventional rehabilitation therapy, and active rTMS was applied daily to the hotspot of the lesional hemisphere. The SCI patients in the control group underwent sham rTMS and conventional rehabilitation therapy. The participants in both the groups received therapy five days per week for six weeks. Latency, amplitude, and velocity were assessed before and after the six-week therapy period. A significant difference in post-treatment gains for the latency and velocity was observed between the experimental and control groups (p < 0.05). However, no significant differences in the amplitude were observed between the two groups (p > 0.05). The results of this study indicate that rTMS may be beneficial in improving motor recovery in the lower extremities of subacute stage SCI patients.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.49-54
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• 2016

PURPOSE: The purpose of this study was to determine the effect of different frequencies (4Hz and 100Hz) of transcutaneous electrical nerve simulation (TENS) on pain relief using c-fos expression in the spinal cord of rat osteoarthritis to investigate the appropriate frequency for pain relief. METHODS: Total of 30 Sprague-Dawley rats was used and randomly divided 2 groups according TENS frequency and applicate the TENS during 3 period (3 days, 7 days, 10 days). The induction of osteoarthritis by 3mg monosodium iodoacetat was injected into the right knee joint of rats. Three days later, commercially available TENS unit was used for stimulation was set to 20minutes on 3, 7, 10 days after surgery. Western blot analysis system was used to detect immunoreactive proteins. The thickness of the bands were photographically measured by Scion Image. RESULTS: When investigating the c-fos expression of TENS on spinal cord in OA knee over 10 days, between-groups differences in c-fos expression reached a significant level by day 10. For within-groups comparisons, the c-fos expression decreased significantly across days in low- and high-frequency TENS groups. CONCLUSION: Whether at low- and high-frequency, the TENS as a therapy obtained beneficial effects of pain relief and TNES at high-frequency is more beneficial effects on the pain relief when TENS applied at injury site.

• The Korean Journal of Pain
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• v.22 no.1
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• pp.107-111
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• 2009

Neuroablation should be performed cautiously because neuropathic pain can occur following denervation of a somatic nerve. A 34-year-old man presented with severe penile pain and allodynia following a selective neurectomy of the sensory nerve that innervated the glans penis for treatment of his premature ejaculation. He was treated with various nerve blocks, including continuous epidural infusion, lumbar sympathetic block and sacral selective transforaminal epidural blocks, as well as intravenous ketamine therapy. However, all of the treatments had little effect on the relief of his pain. We performed spinal cord stimulation as the next therapy. After this therapy, the patient has currently been satisfied for 3 months.

• The Korean Journal of Pain
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• v.28 no.1
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• pp.57-60
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• 2015

Sphincter of Oddi dysfunction (SOD) is a syndrome of chronic biliary pain or recurrent pancreatitis due to the functional obstruction of the pancreaticobiliary flow. We report a case of spinal cord stimulation (SCS) for chronic abdominal pain due to SOD. The patient had a history of cholecystectomy and had suffered from chronic right upper quadrant abdominal pain. The patient had been diagnosed as having SOD. The patient was treated with opioid analgesics and nerve blocks, including a splanchnic nerve block. However, two years later, the pain became intractable. We implanted percutaneous SCS at the T5-7 level for this patient. Visual analog scale (VAS) scores for pain and the amount of opioid intake decreased. The patient was tracked for more than six months without significant complications. From our clinical case, SCS is an effective and alternative treatment option for SOD. Further studies and long-term follow-up are necessary to understand the effectiveness and the limitations of SCS on SOD.

• Physical Therapy Korea
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• v.2 no.1
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• pp.62-70
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• 1995

The use of electricity to evoke s skeletal muscle response is FES, which is a form of functional electrical stimulation. In the case of the damaged spinal cord, the technique can supply stimulation to the lower moter neurons and their muscle fiber, which have been disconnected from control of the higher nervous system. Recent advances in electronics, particularly miniaturization, have made possible the design of much improved systems of electrodes and stimulaters for FES. Clinical research has followed two main lines: the use of FES in the upper extremities for producing functional hand rehabilitation in quadriplegics and in the lower extremities for producing standing and gait in paraplegics.

• Restorative Dentistry and Endodontics
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• v.26 no.5
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• pp.436-442
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• 2001

Neuropeptide such as calcitonin gene-related peptide and substance P may mediate neurogenic inflammation, but little is known about the regulation of neuropeptide release from rat spinal cord. Eugenol has been reported to reduce odontogenic pain and is known to have a structure similar to capsaicin, a potent stimulant of certain nociceptors. This study was done to examine the effect of capsaicin and eugenol on immunoreactive calcitonin gene-related peptide (iCGRP) release from rat spinal cord and whether eugenol regulates capsaicin-sensitive release of iCCRP or it evokes capsaicin-sensitive release of iCGRP. The dor-sal half of rat lumbar spinal cord was chopped into 200$\mu$m slices. They were superfused (500$\mu$l/min) in vitro with an oxygenated Kreb's buffer. The EC$_{50}$ of capsaicin on iCGRP release was measured. Eugenol (600$\mu$M and 1.2mM) and vehicle (0.02% 2-hydroxyl-$\beta$-cyclodextrin) were administered prior to stimulation of rat lumbar spinal cord with capsaicin. The amount of iCGRP release from rat lumbar spinal cord was measured by radioimmunoassay. The results were as follows : 1. iCGRP release from rat lumbar spinal cord was dependent on concentration of capsaicin. The EC$_{50}$ of capsaicin on iCGRP release was 3$\mu$M. 2. In the vehicle treated group, capsaicin (3$\mu$M) evoked a 14-fold increase over basal iCGRP level. 3. Administration of 600$\mu$M and 1.2mM eugenol evoked a 2.2-fold increase and a 2.3-fold increase over basal iCGRP level respectively. 4. Administration of 600$\mu$M and 1.2mM eugenol increased capsaicin evoked release of iCGRP by more than 50%. These results indicate that eugenol evoke CGRP release from central nervous system and potentiate the pain-inducing action of capsaicin on it.