IMR Press / JIN / Volume 22 / Issue 3 / DOI: 10.31083/j.jin2203067
Open Access Original Research
Spinal Cord Stimulation Alleviates Pain Hypersensitivity by Attenuating Neuroinflammation in a Model of Painful Diabetic Neuropathy
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1 Department of Pain Medicine, Jingzhou Hospital Affiliated to Yangtze University, 434020 Jingzhou, Hubei, China
2 Department of Anesthesiology, Hankou Hospital, 430012 Wuhan, Hubei, China
3 Department of Pain Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430032 Wuhan, Hubei, China
*Correspondence: (Nianyun Wang); (Ying Wang)
These authors contributed equally.
J. Integr. Neurosci. 2023, 22(3), 67;
Submitted: 6 November 2022 | Revised: 28 November 2022 | Accepted: 30 November 2022 | Published: 9 May 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Introduction: Painful diabetic neuropathy (PDN) is an intractable chronic pain condition affecting a growing number of adults in China. Spinal cord stimulation (SCS) has been employed in the treatment of PDN for several decades. However, the efficacy and underlying mechanisms of SCS are still inconclusive. Methods: In this study, we adopted an implantable pulse generator to deliver electrical stimulation (50 Hz, 200 us pulse width, 12 hours/day in 5 weeks) via a quadripolar electrode in the lumbar epidural space to treat pain hypersensitivity in the rat model of PDN. Electronic von Frey and Hargreaves tests were used to measure the responses to mechanical and heat stimuli, respectively. Quantitative PCR, western blotting, and enzyme-linked immunosorbent assay (ELISA) were adopted to explore the changes in neuroinflammation after SCS. Results: SCS alleviated mechanical allodynia and heat hyperalgesia over a period of 3 weeks in diabetic rats. SCS completely suppressed neuropathy-induced Tlr4 and NFκB p65 elevation, resulting in the reduction of pain-promoting Il1β, Il6, and Tnfα proteins in the spinal cord dorsal horn. Conclusions: SCS may alleviate diabetic neuropathy-induced pain hypersensitivity via attenuating neuroinflammation in the spinal cord dorsal horn.

diabetic neuropathies
spinal cord stimulation
chronic pain
2018CKB920/Natural Science Foundation of Hubei Province
Fig. 1.
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