• Helwin Smits, Maarten V Kleef, Wiel Honig, Job Gerver, Philipp Gobrecht, and Elbert A J Joosten.
• Pain Management and Research Center, Department of Anaesthesiology, Maastricht University Hospital, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands. h.smits@np.unimaas.nl
• Neurosci. Lett. 2009 Jan 23;450(1):70-3.

AbstractSpinal cord stimulation (SCS) is an established treatment for intractable neuropathic pain, especially CRPS-1. The mechanisms of action of SCS have only been partly elucidated and include suppression of the hyper-excitability of the Wide Dynamic Range neurons and a GABA increase in the dorsal horn. In the present study we demonstrate an increase of c-Fos immunoreactive cells in the dorsal horn after SCS, suggesting early cellular activation that may preclude earlier described electrophysiological and biochemical changes in the dorsal horn after SCS. In a rat model of neuropathic pain, allodynia was induced and quantified using the von Frey test. In 11 rats a SCS device was implanted and spinal cord stimulation performed. Withdrawal threshold were measured every 15 min up to 90 min. A sham group (n=6) also had a SCS device implanted, but did not receive SCS. After SCS the animals were perfused and histology was performed for quantification of c-Fos immunoreactivity in the dorsal horns. We found a significant increase in c-Fos in the SCS group compared to our sham group and control tissue, indicating late cellular activity in the dorsal horn after SCS.

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