2/17/2024 0 Comments Free download Shoulders of Giants![]() ![]() Our aim was to perform a literature review of studies that used objective measures to characterize mechanisms of action of SCS in neuropathic pain patients. Objective: The physiological mechanisms behind the therapeutic effects of spinal cord stimulation (SCS) are only partially understood. Experimental data in both animals and humans support these 21 conclusions. When applied to remote areas, the techniques might be related to ‘‘counter- 19 irritation’’ or ‘‘counter-stimulation’’ phenomena which, in addition to involving complex autonomic 20 functions, seem to involve DNIC. When applied near a painful focus, the techniques have similarities to high- 17 frequency, low-intensity transcutaneous nerve stimulation, which brings segmental inhibitory 18 mechanisms into play. Both these mechanisms could be triggered to produce hypoalgesia by acupuncture 16 needles or moxibustion. Combined psychophysical 13 measurements and recordings of nociceptive reflexes (RIII) in both normal volunteers and patients 14 with lesions in the spinal cord or brain suggest the existence of identical or equivalent inhibitory 15 processes in man. rubbing, etc.) Diffuse noxious 10 inhibitory controls (DNIC) are triggered by peripheral Ay- and C-fibres, involve brain structures 11 confined to the caudal-most part of the medulla including the subnucleus reticularis dorsalis (SRD) 12 and are mediated by descending pathways in the dorsolateral funiculi. ![]() Spinal networks underlie segmental inhibitions, which are mediated via myelinated 9 cutaneous afferent fibres activated by mechanical stimuli (e.g. ![]() ![]() The spinal transmission of nociceptive signals is modulated by both spinal and supraspinal 8 systems. ![]()
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