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- W1483754914 abstract "Background: Maximal High Voltage Electrical Stimulation (HVES) of lumbosacral nerve root (4-6 stimuli, 15-20 seconds apart), delivered at the optimal stimulation site (OSS) on the vertebral column (Troni et al, 2011), produces an almost immediate, transient (few hours) but prominent, homo- and heterotopic analgesic effects (average pain reduction of 70%; Troni et al., 2013a,b). The question arises whether analgesia simply represents a “counter-irritation” effect due to the local pain caused by HVES.Objective: To approach the mechanisms of analgesia induced by root HVES.Design/Method: In 10 patients with acute or chronic nociceptive or mixed pain due to shoulder or coxo-femoral arthropathies, cervical or lumbosacral radiculopathies, a strictly local, Painful Skin Stimulation (PSS) was performed at the OSS through two surface electrodes placed 2 cm apart. Six stimuli, 15-20 seconds apart, were delivered with a HVE Stimulator using a stimulus intensity eliciting a pain similar to that on average induced by root HVES (BS-11 verbal score: 6-7). The procedure was proposed as a technique “with possible analgesic effects”. The following day, root HVES was performed and proposed as “a technique similar to the previous one with possible analgesic effects”. Pain was monitored for at least 12 hour using the BS-11 verbal score.Results: In no case PSS induced significant analgesic effects in spite of positive expectations. In all cases root HVES induced an analgesic effect of usual magnitude and showing a similar time course in spite of negative expectations due to the disappointing results of the previous procedure.Conclusions: Our results prove that analgesia to root HVES does not simply stem from a local conditioning pain. Compelling evidence accordingly indicates that root HVES cannot achieve activation of the high-threshold, small myelinated and unmyelinated nociceptive fibres of dorsal nerve roots. This suggests that analgesia to HVES requires activation of large-diameter afferent fibres of dorsal roots. Disclosure: Dr. Troni has nothing to disclose. Dr. Melillo has nothing to disclose. Dr. di Sapio has received personal compensation for activities with Biogen Idec, Novartis, Teva Neuroscience, Merck Serono, Farmades and Aventis Pharmaceuticals Inc. Dr. Bertolotto has received personal compensation for activities with Biogen Idec, Merck & Co. Inc., Farmades, Novartis, and Aventis Pharmaceuticals Inc. Dr. Bertolotto has received research support from Serono, Inc., Farmades, Aventis Pharmaceuticals Inc., and Biogen Idec." @default.
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- W1483754914 date "2014-04-08" @default.
- W1483754914 modified "2023-09-23" @default.
- W1483754914 title "Approaching The Mechanisms Underlying Analgesia Induced By High Voltage Electrical Stimulation Of Lumbosacral Nerve Roots (P7.315)" @default.
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