Burst Spinal Cord Stimulation in a Rat Model of Chronic Neuropathic pain: Spinal and Supraspinal Mechanisms

The results of this thesis show that there is a complex relationship between the analgesic effect and the parameters of burst spinal cord stimulation. Preclinical behavioural tests have shown that a delayed wash-in of the analgesic effect occurs in burst spinal cord stimulation compared to tonic spinal cord stimulation. In addition, in a renowned animal model for chronic neuropathic pain, it was demonstrated that Gamma-amino butyric acid (GABA)-ergic mechanisms underlie the analgesic effect of both burst spinal cord stimulation and tonic spinal cord stimulation. Using an innovative new behavioural test in combination with functional Magnetic Resonance Imaging (MRI) research, we demonstrated that both burst spinal cord stimulation and tonic spinal cord stimulation induce increased brain activity in brain regions involved in processing cognitive-emotional aspects of pain. However, for burst spinal cord stimulation, the relevant activity was more intense and widespread. In summary, burst spinal cord stimulation has similarities as well as differences with tonic spinal cord stimulation. It is important that the differences will be further investigated in the future in order to optimally utilize the analgesic effectiveness of burst spinal cord stimulation.