ABSTRACT
Pulsed radiofrequency (PRF) is effective in the treatment of neuropathic pain in clinical practice. Its application to sites proximal to nerve injury can inhibit the activity of extra-cellular signal-regulated kinase (ERK) for up to 28 days. The spared nerve injury (SNI)+ immPRF group (immediate exposure to PRF for 6 min after SNI) exhibited a greater anti-allodynic effect compared with the control group (SNI alone) or the SNI + postPRF group (application of PRF for 6 min on the 14th day after SNI). Insulin-like growth factor 2 (IGF2) was selected using microarray assays and according to web-based gene ontology annotations in the SNI + immPRF group. An increase in IGF2 and activation of ERK1/2 were attenuated by the immPRF treatment compared with an SNI control group. Using immunofluorescent staining, we detected co-localized phosphorylated ERK1/2 and IGF2 in the dorsal horn regions of rats from the SNI group, where the IGF2 protein predominantly arose in CD11b- or NeuN-positive cells, whereas IGF2 immunoreactivity was not detected in the SNI + immPRF group. Taken together, these results suggest that PRF treatment immediately after nerve injury significantly inhibited the development of neuropathic pain with a lasting effect, most likely through IGF2 down-regulation and the inhibition of ERK1/2 activity primarily in microglial cells.
Subject(s)
Gene Expression Regulation , Hyperalgesia/genetics , Hyperalgesia/therapy , Insulin-Like Growth Factor II/genetics , Neuralgia/genetics , Neuralgia/therapy , Pulsed Radiofrequency Treatment , Animals , Cluster Analysis , Computational Biology/methods , Disease Models, Animal , Down-Regulation , Gene Expression Profiling , Hyperalgesia/metabolism , Insulin-Like Growth Factor II/metabolism , Mitogen-Activated Protein Kinase 1/metabolism , Mitogen-Activated Protein Kinase 3/metabolism , Molecular Sequence Annotation , Neuralgia/metabolism , Pain Measurement , Phosphorylation , Rats , Reproducibility of Results , Signal TransductionABSTRACT
INTRODUCTION: Spinal cord stimulation (SCS) is an efficient procedure for treatment of intractable pain. METHODS: We present a patient who underwent SCS lead placement for severe left lower extremity pain. The patient had experienced good pain. He underwent thermographic imaging before, just after and ten days later of procedure. RESULTS: Thermogram study revealed from blue color (hypothermic) pattern at before procedure to reddish or pink color (hyperthermic) pattern at ten days later. DISCUSSION: SCS may be increase microcirculation and seems to have sympatholytic effects. CONCLUSION: We experienced that improvement of blood flow as result of SCS in CRPS.