administration of transcutaneous electrical nerve stimulator (tens) manipulation in a chronic constriction injury rat model

ラットモデルにおけるFSN療法の改善:不快感の最小化と効率の最大化

Neuropathic pain, defined as pain caused by nerve damage, is estimated to affect 6.9%-10% of the world&#39;s population, and the reported lifetime prevalence is 49%-70%1,2. It is also considered to be one of the most difficult pain syndromes to manage. The use of pharmacological agents to manage neuropathic pain has yielded limited success as commonly prescribed pain medications like non-steroidal anti-inflammatory drugs and opioids have shown little efficacy in relieving this type of pain3,4. There is therefore a great need to explore new treatment options, especially non-pharmacological treatments. Acupuncture, as a non-pharmacological intervention, potentially alleviate neuropathic pain by exerting analgesic effects on the somatosensory system. Both clinical and preclinical studies have indicated that acupuncture is effective in relieving neuropathic pain symptoms without significant side effects5,6,7. However, the central mechanism of acupuncture treatment for pain relief in neuropathic pain remains to be further investigated.
In recent years, Fu&#39;s subcutaneous needling (FSN) has gained popularity for treating pain-related neurological disorders8. FSN originated from traditional Chinese acupuncture and was first described by traditional Chinese physician Zhonghua Fu in 19969,10. While originating from traditional acupuncture, FSN differs significantly in its techniques and theories from meridian-based acupuncture, yin and yang principles, and acupuncture point concepts. FSN places greater emphasis on neurophysiological and anatomical approaches to effectively address myofascial pain11. FSN therapy is applied in clinical practice to address various painful muscular disorders, targeting the connective tissues closely associated with the muscles, particularly focusing on the treatment of tightened muscles (TMs)12. As a complementary therapy for pain relief, there is also clinical evidence that FSN is effective in treating soft tissue injuries in addition to providing rapid pain management and significant improvement in soft tissue spasms13,14. FSN therapy involves specific techniques tailored to address the underlying myofascial trigger points (MTrPs) associated with the condition. The FSN needle insertion position is carefully chosen based on the location of these trigger points, allowing precise targeting of affected areas. During the procedure, the FSN needle is inserted into the subcutaneous layer, where it is intentionally stopped to optimize therapeutic effects. A distinctive technique known as the swaying movement is then employed, involving a gentle oscillating motion of the needle to stimulate the tissues and promote the therapeutic responses10. The development of MTrPs is associated with the energy crisis theory, which explains that factors such as chronic muscle overload, excessive exercise, improper exertional postures, muscle atrophy, and degeneration can contribute to the onset of muscle tissue ischemia and hypoxia. This oxygen and energy deficiency within the muscle tissue is believed to play a key role in the formation of MTrPs15,16. Previous animal studies have found that FSN treatment for chronic pain in rats improves the morphological structure and function of mitochondria in TMs to some extent, validating the potential of FSN therapy to promote the recovery of damaged nerves and muscles17.
Sciatica has been classified as neuropathic pain18. The origin of neuropathic pain is thought to lie anywhere between the motor endplate and the outer fibrous layer of the muscle, involving the microvascular system and neurotransmitters at the cellular level. Loss of muscle innervation and apoptosis of innervated nerve cells occurs when nerve damage occurs19, leading to pain-related gait in the affected limb. Additionally, chronic compression or irritation of the nerve can lead to a variety of changes in the way of nerve functions, which can further exacerbate the symptoms of sciatica20. However, the complexity of the nervous system makes it difficult to replicate it in vitro, thus necessitating the use of animal models for such studies. In the investigation of neuropathic pain disorders, model organisms are commonly employed, involving various methods of direct peripheral nerve injury, such as sciatic nerve ligature, transection, or compression21,22. The chronic constriction injury (CCI) model in Sprague-Dawley rats has been used to induce neuropathic pain. This model replicates the pain induced by nerve injury observed in humans through surgical constriction of a peripheral nerve, mimicking the compression or entrapment seen in conditions such as nerve compression syndromes and peripheral neuropathies.
In this study, we evaluated the analgesic effects of FSN therapy and low-frequency electrotherapy (transcutaneous electrical nerve stimulator, TENS) in rats with chronic constriction injury and neuropathic pain. As anesthesia slows or blocks nerve impulses and affects synaptic transmission and neuronal function23, animals cannot be anesthetized under all needling procedures and swaying movements. Therefore, an appropriate needle technique is required to reduce discomfort in rats. The steps for establishing a rat CCI model, the way the rats were treated with FSN combined swaying movement without anesthesia, feasible animal behavioral pattern tests, and electrophysiological investigations are described in detail.

著者スポットライト:FSN治療の治療効果を明らかにする – 神経障害性疼痛における研究と臨床応用の橋渡し

坐骨神経痛に対するフー皮下ニードリングの有効性:慢性狭窄損傷ラットモデルにおける行動的および電気生理学的変化

慢性狭窄傷害ラットモデルにおける経皮的電気神経刺激装置(TENS)マニピュレーションの投与

Research

JoVE Journal

Medicine

Administration of Transcutaneous Electrical Nerve Stimulator (TENS) Manipulation in a Chronic Constriction Injury Rat Model

Efficacy of Fu's Subcutaneous Needling on Sciatic Nerve Pain: Behavioral and Electrophysiological Changes in a Chronic Constriction Injury Rat Model

Fu&#39;s subcutaneous needling (FSN), an invented acupuncture technique from traditional Chinese medicine, is used worldwide for pain relief. However, the ...

医学

Establishment of a Rat Chronic Constriction Injury Model

ラット慢性狭窄傷害モデルの確立

Administration of Fu&#39;s Subcutaneous Needling (FSN) Manipulation in a Chronic Constriction Injury Rat Model

慢性狭窄傷害ラットモデルにおけるFuの皮下ニードリング(FSN)操作の投与