PhD Conferral Mr. Koenraad P.V. Meuwissen, MSc.
Supervisors: prof.dr. E.A.J. Joosten; prof.dr. M. van Kleef
“Burst Spinal Cord Stimulation in a Rat Model of Chronic Neuropathic Pain: Spinal and Supraspinal Mechanisms”
The results of this academic thesis show that there is a complex relationship between the analgesic effect and the parameters of burst spinal cord stimulation. Preclinical behavioral 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, we have 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 behavioral 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 activity in question was more intense and more widespread. In summary, burst spinal cord stimulation has similarities and differences with tonic spinal cord stimulation. It is important that the differences in the future are further investigated in order to optimally utilize the analgesic effectiveness of burst spinal cord stimulation.