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      Conventional Dorsal Root Ganglion Stimulation in an Experimental Model of Painful Diabetic Peripheral Neuropathy: A Quantitative Immunocytochemical Analysis of Intracellular γ‐Aminobutyric Acid in Dorsal Root Ganglion Neurons

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          ABSTRACT

          Background and Objective

          The sensory cell somata in the DRG contain all equipment necessary for extensive GABAergic signaling and are able to release GABA upon depolarization. With this study, we hypothesize that pain relief induced by conventional dorsal root ganglion stimulation (Con‐DRGS) in animals with experimental painful diabetic peripheral neuropathy is related to the release of GABA from DRG neurons. With use of quantitative immunocytochemistry, we hypothesize DRGS to result in a decreased intensity of intracellular GABA‐immunostaining in DRG somata.

          Materials and Methods

          Female Sprague‐Dawley rats ( n = 31) were injected with streptozotocin (STZ) in order to induce Diabetes Mellitus. Animals that developed neuropathic pain after four weeks (Von Frey) were implanted with a unilateral DRGS device at L4 ( n = 14). Animals were then stimulated for 30 min with Con‐DRGS (20 Hz, pulse width = 0.2 msec, amplitude = 67% of motor threshold, n = 8) or Sham‐DRGS ( n = 6), while pain behavior (von Frey) was measured. DRGs were then collected and immunostained for GABA, and a relation to size of sensory cell soma diameter (small: 12–26 μm, assumed to be C‐fiber related sensory neurons; medium: 26–40 μm, assumed to be Aδ related sensory neurons; and large: 40–54 μm, assumed to be Aβ related sensory neurons) was made.

          Results

          DRGS treated animals showed significant reductions in STZ‐induced mechanical hypersensitivity. No significant differences in GABA immunostaining intensity per sensory neuron cell soma type (small‐, medium‐, or large‐sized) were noted in DRGs of stimulated (Con‐DRGS) animals versus Sham animals. No differences in GABA immunostaining intensity per sensory cell soma type in ipsi‐ as compared to contralateral DRGs were observed.

          Conclusion

          Con‐DRGS does not affect the average intracellular GABA immunofluorescence staining intensity in DRG sensory neurons of those animals which showed significant pain reduction. Similarly, no soma size related changes in intracellular GABA immunofluorescence were observed following Con‐DRGS.

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          Most cited references43

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          Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial

          A comparative effectiveness trial indicates that dorsal root ganglion stimulation provided a higher rate of treatment success with less postural variation in paresthesia intensity compared to spinal cord stimulation.
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            • Record: found
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            Pain mechanisms: a new theory.

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              Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report.

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                Author and article information

                Contributors
                g.franken@maastrichtuniversity.nl
                Journal
                Neuromodulation
                Neuromodulation
                10.1111/(ISSN)1525-1403
                NER
                Neuromodulation
                John Wiley & Sons, Inc. (Hoboken, USA )
                1094-7159
                1525-1403
                04 May 2021
                June 2021
                : 24
                : 4 ( doiID: 10.1111/ner.v24.4 )
                : 639-645
                Affiliations
                [ 1 ] Department of Anesthesiology and Pain Management Maastricht University Medical Centre (MUMC+) Maastricht The Netherlands
                [ 2 ] School for Mental Health and Neuroscience (MHeNS), Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht The Netherlands
                [ 3 ] Department of Urology Maastricht University Medical Centre (MUMC+) Maastricht The Netherlands
                [ 4 ] Department of Surgery Maastricht University Medical Centre (MUMC+) Maastricht The Netherlands
                [ 5 ] Muroidean Facility, School of Cardiovascular Diseases (CARIM) Maastricht The Netherlands
                Author notes
                [*] [* ] Address correspondence to: Glenn Franken, PhD, Department of Anesthesiology and Pain Management, Pain Management and Research Centre, Maastricht University Hospital, P.O. Box 616, Maastricht, The Netherlands. Email: g.franken@ 123456maastrichtuniversity.nl

                Author information
                https://orcid.org/0000-0002-5596-1058
                https://orcid.org/0000-0002-6708-6545
                Article
                NER13398
                10.1111/ner.13398
                8360133
                33942947
                dcfdff3b-c18c-4a63-ae59-2344124e7434
                © 2021 The Authors. Neuromodulation: Technology at the Neural Interface published by Wiley Periodicals LLC on behalf of International Neuromodulation Society.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 26 February 2021
                : 30 November 2020
                : 15 March 2021
                Page count
                Figures: 2, Tables: 0, Pages: 7, Words: 6504
                Categories
                Basic Research
                DORSAL ROOT GANGLION STIMULATION
                Basic Research
                Custom metadata
                2.0
                June 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.5 mode:remove_FC converted:12.08.2021

                dorsal root ganglion stimulation,gaba,neuromodulation,neuropathic pain,painful diabetic peripheral neuropathy

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