Lab Anim Res.  2010 Sep;26(3):225-232.

Neuronal Hyperexcitability Mediates Below-Level Central Neuropathic Pain after Spinal Cord Injury in Rats

Affiliations
  • 1Koatech Co., Pyeongtaek, Korea.
  • 2Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Korea.
  • 3Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea.
  • 4Department of Oral physiology, School of Dentistry and BK21, Kyungpook National University, Daegu, Korea.
  • 5Department of Neuroscience and Cell Biology, University of Texas Medical Branch at Galveston, Galveston, USA. ysgwak@utmb.edu

Abstract

Spinal cord injury often leads to central neuropathic pain syndromes, such as allodynic and hyperalgesic behaviors. Electrophysiologically, spinal dorsal horn neurons show enhanced activity to non-noxious and noxious stimuli as well as increased spontaneous activity following spinal cord injury, which often called hyperexcitability or central sensitization. Under hyperexcitable states, spinal neurons lose their ability of discrimination and encoding somatosensory information followed by abnormal somatosensory recognition to non-noxious and noxious stimuli. In the present review, we summarize a variety of pathophysiological mechanisms of neuronal hyperexcitability for treating or preventing central neuropathic pain syndrome following spinal cord injury.

Keyword

Central neuropathic pain; hyperexcitability; rat model

MeSH Terms

Animals
Central Nervous System Sensitization
Discrimination (Psychology)
Neuralgia
Neurons
Posterior Horn Cells
Rats
Spinal Cord
Spinal Cord Injuries

Figure

  • Figure 1. Hyperexcitability of lumbar spinal dorsal horn neurons following low thoracic spinal cord injury. All phenotypes of lumbar spinal dorsal horn neurons showed significantly increased evoked activity in response to mechanical stimuli applied on the receptive field compared to sham controls. Low threshold (LT) neurons showed significant increase of brush evoked activity whereas high threshold (HT) neurons showed significantly increased activity to pressure and pinch stimuli, respectively. Wide dynamic range (WDR) neurons showed significantly increased activity to all three different mechanical stimuli. Br: brush, Pr: pressure, Pi: pinch stimuli. ∗P<0.05.

  • Figure 2. Attenuation of neuronal hyperexcitability and mechanical allodynia by γ-aminobutyric acid (GABA) receptor agonist. (A) shows typical histograms of wide dynamic range (WDR) neurons in response to brush, pressure and pinch stimuli applied on the peripheral receptive field. (B) shows attenuation of WDR activity by topical application of baclofen (GABAB receptor agonist) in the lumbar spinal dorsal horn following low thoracic spinal cord injury. (C) shows attenuation of mechanical allodynia by intrathecal application of baclofen following spinal cord injury. ∗P<0.05 compared to control values; #P<0.05 compared to pre-drug (before) values. Modified from Gwak et al. (2006).

  • Figure 3. Intracellular signaling pathway for neuronal hyperexcitability. Following spinal cord injury, massive influx of calcium ions through calcium-permeable channels into cytoplasm initiates activation of mitogen-associated protein kinase (MAPK) family followed by activation of transcription factors, which result in altered target protein expression, such as phosphorylation of receptors and ion channels in the membrane. Activation of ion channels and receptors directly contributed to neuronal hyperexcitability. This positive feedback maintains persistent hyperexcitability of spinal dorsal horn neurons following spinal cord injury.


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