ID: 202712 Loss of Conduction Fidelity in Dorsal Column Axons During Spinal Cord Stimulation With Conventional Frequencies

Abstract

Epidural spinal cord stimulation (SCS) is an effective therapy for chronic pain, but there remains an opportunity to increase efficacy and response rates. Conventional paresthesia-producing SCS delivers pulse repetition frequencies < 200 Hz. SCS produces analgesia by activating large dorsal column axons which innervate inhibitory interneurons in the dorsal horn (Gate control theory). This understanding and contemporary research presume that dorsal column (DC) axons propagate faithfully every time a stimulation pulse is delivered. However, recent computational studies suggested that there may be a loss of conduction fidelity, or faithful propagation of an action potential for each stimulation pulse, depending on the stimulation frequency. We measured the response of single dorsal column axons to epidural SCS in healthy urethane-anesthetized Sprague-Dawley rats.