• Koen P V Meuwissen, Jianwen Wendy Gu, Tianhe C Zhang, and Joosten Elbert A J EAJ Pain Management and Research Centre, Department of Anesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, the Nether.
• Pain Management and Research Centre, Department of Anesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, the Netherlands.
• Pain Pract. 2018 Nov 1; 18 (8): 988-996.

ObjectiveTwo well-known spinal cord stimulation (SCS) paradigms, conventional (Con) and burst SCS, are hypothesized to exert their antinociceptive effects through different stimulation-induced mechanisms. We studied the course of the behavioral antinociceptive effect during 60 minutes of SCS and 30 minutes post-SCS in a rat model of chronic neuropathic pain.MethodsAnimals underwent a unilateral partial sciatic nerve ligation, after which quadripolar electrodes were implanted into the epidural space at vertebral level T13 (n = 43 rats). While receiving either Con SCS or biphasic burst SCS, the pain behavior of the rats was assessed by means of paw withdrawal thresholds (WTs) in response to the application of von Frey monofilaments.ResultsAfter 15 minutes of Con SCS (n = 21), WTs significantly differed from baseline (P = 0.04), whereas WTs of the burst SCS group (n = 22) did not. After 30 minutes of SCS, WTs of the Con SCS and burst SCS groups reached similar levels, both significantly different from baseline, indicating a comparable antinociceptive effect for these SCS paradigms. Yet, the WTs of the burst SCS group were still significantly increased compared with baseline at 30 minutes post-stimulation, whereas the WTs of the Con SCS group were not.ConclusionsTo conclude, biphasic burst SCS results in a delayed antinociceptive effect after onset of the stimulation, as compared with Con SCS, in a chronic neuropathic pain model. Furthermore, biphasic burst SCS seems to exhibit a delayed wash-out of analgesia after stimulation is turned off.© 2018 World Institute of Pain.

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