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The Journal of Neuroscience, October 1, 1999, 19(19):8589-8596
Membrane Potential Oscillations in Dorsal Root Ganglion Neurons:
Role in Normal Electrogenesis and Neuropathic Pain
Ron
Amir1,
Martin
Michaelis2, and
Marshall
Devor1
1 Department of Cell and Animal Biology, Institute of
Life Sciences, Hebrew University of Jerusalem, Jerusalem 91904, Israel,
and 2 Physiologisches Institut, Christian-Albrechts
Universitat, 24098 Kiel, Germany
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ABSTRACT |
Abnormal afferent discharge originating at ectopic sites in injured
primary sensory neurons is thought to be an important generator of
paraesthesias, dysaesthesias, and chronic neuropathic pain. We report
here that the ability of these neurons to sustain repetitive discharge
depends on intrinsic resonant properties of the cell membrane and that
the prevalence of this characteristic increases after nerve injury.
Recording from primary sensory neurons in excised rat dorsal root
ganglia, we found that some cells show subthreshold oscillations in
their membrane potential. The amplitude, frequency, and coherence of
these oscillations were voltage sensitive. Oscillations gave rise to
action potentials when they reached threshold. Indeed, the presence of
oscillations proved to be a necessary condition for sustained spiking
both at resting membrane potential and on depolarization; neurons
without them were incapable of sustained discharge even on deep
depolarization. Previous nerve injury increased the proportion of
neurons sampled that had subthreshold oscillations, and hence the
proportion that generated ectopic spike discharge. Oscillatory behavior
and ectopic spiking were eliminated by
[Na+]o substitution or bath
application of lidocaine or tetrodotoxin (TTX), under conditions that
preserved axonal spike propagation. This suggests that a TTX-sensitive
Na+ conductance contributes to the oscillations.
Selective pharmacological suppression of subthreshold oscillations may
offer a means of controlling neuropathic paraesthesias and pain without
blocking afferent nerve conduction.
Key words:
dorsal root ganglion; ectopic firing; paraesthesias; neuropathic pain; subthreshold oscillations; rat
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INTRODUCTION |
Nerve injury is frequently followed
by paraesthesias, dysaesthesias, and severe pain. These
"neuropathic" symptoms are poorly responsive to existing analgesic
drugs, and represent a major unsolved health problem (Sunderland, 1978 ;
Bonica, 1990 ). An important generator of neuropathic pain is thought to
be abnormal discharge that develops at ectopic (i.e., abnormal) sites
in some injured sensory neurons (Nordin et al., 1984 ; Kuslich et
al., 1991 ; Devor, 1994 ; Xie et al., 1995 ; Study and Kral, 1996 ). This
ectopic discharge appears to directly evoke ongoing paraesthesias and
pain. In addition, it may also trigger and maintain "central
sensitization," a CNS hyperexcitability state in which normally
non-noxious input carried on large myelinated A touch afferents is
felt as painful (allodynia) (Woolf, 1983 ; Campbell et al., 1988 ). Both
ongoing pain and allodynia are eliminated by preventing ectopic
discharge from gaining access to the CNS (Gracely et al., 1992 ; Sheen
and Chung, 1993 ).
It is generally presumed that ectopic neuropathic discharge results
from the classical (Hodgkin-Huxley) repetitive firing process whereby a
sustained depolarization repeatedly draws the membrane potential toward
threshold (Jack et al., 1985 ). We now report evidence that the
discharge in fact results from a quite different process. Recording
from rat dorsal root ganglia (DRGs) in vitro we found that a
considerable proportion of primary sensory neurons of specific types
show sinusoidal voltage oscillations in their membrane potential.
Ectopic spikes generated in these DRG neurons always emerged from the
rising phase of the sinusoids and hence appear to be triggered by the
oscillations. DRG neurons without oscillations were unable to generate
sustained discharge even when deeply depolarized, indicating that the
oscillatory process is a necessary condition for repetitive firing in
this type of neuron.
Chronic nerve injury, a condition associated with enhanced
TTX-sensitive Na+ conductance (Rizzo et
al., 1996 ; Study and Kral, 1996 ; Cummins and Waxman, 1997 ), was found
to increase the prevalence of neurons exhibiting subthreshold
oscillations and consequently the magnitude of the resulting ectopic
discharge. On the other hand, partial substitution of
Na+ ions in the bath, or bath application
of low concentrations of lidocaine or TTX, eliminated the oscillations,
and with them the ectopic discharge. This occurred at times when
impulse propagation along the afferent axons was spared. These
observations suggest that pharmacological agents capable of suppressing
the oscillatory process in primary afferent neurons should suppress
ectopic discharge and associated neuropathic symptoms.
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MATERIALS AND METHODS |
Immature (22-88 gm, 2-5 weeks of age) and adult (165-530 gm)
male and female rats of the Wistar-derived Sabra strain were deeply
anesthetized (Nembutal, CEVA, Paris, France; >60 mg/kg, i.p) and
killed by carotid exsanguination. DRGs L4 and L5 with the dorsal root
(DR) and a variable length of the spinal/sciatic nerve attached were
excised. In some adult animals the sciatic nerve was tightly ligated
with 5-0 silk and cut just distal to the ligature 2-15 d before
excision. All work adhered to national, university, and International
Association for the Study of Pain guidelines for the humane care and
use of laboratory animals. After ~1 hr recovery in a modified Krebs
solution containing (in mM): NaCl 124, NaHCO3 26, KCl 3, NaH2PO4 1.3, MgCl 2, dextrose 10, and saturated with 95% O2 and 5%
CO2, pH 7.4 (290-300 mOsm, room temperature),
the tissue was mounted in a recording chamber and superfused with the
Krebs solution (1-2 ml/min, room temperature or 37°C) to which 2 mM CaCl2 was added. In some
experiments in adult rats, the 124 mM NaCl in the bath was
replaced with 124 mM choline-Cl (Sigma, St. Louis, MO). The
recording chamber was set on a massive table top isolated from external
vibrations by air suspension (Micro-g, Technical Manufacturing,
Peabody, MA.)
The DRG capsule was slit open in ganglia from mature rats but left
intact in ganglia taken from immature rats. Sharp glass microelectrodes
were used for intracellular recording and stimulation (20-40 M
filled with 3 M KCl) of DRG neurons. Intracellular stimuli were either brief steps (1 msec), prolonged steps (~80 msec to >2
sec), or ramp-and-hold stimuli (rise time 2 sec > >0.1 sec, hold >2 sec). Axonal stimuli, applied to the nerve through an Ag/AgCl
electrode pair, were monophasic, 0.1-0.2 msec square pulses, 7mA.
The evoked compound action potential was monitored on the DR through a
recording suction electrode and served as an indicator of spike
propagation through the ganglion. Resting membrane potential was more
negative than 40 mV, and on single-pulse intracellular (somatic) or
axonal stimulation there was always an overshooting spike.
DRG neurons were categorized by axon conduction velocity (CV) and the
shape of the intracellularly recorded spike. Briefly, we took the axon
to be myelinated (A-neuron) if CV 1 m/sec. Cells with CV <1 m/sec
were designated as having nonmyelinated axons (C-neurons). In the few
cases in which CV was not established, cells were assumed to be
A-neurons if they had no inflection on the falling phase of the spike
and/or spike width <2 msec at one-half peak-to-peak amplitude.
A-neurons were further categorized on the basis of whether the spike
evoked by intracellular or axonal stimulation was narrow and lacked an
inflection of its falling phase (A0-neurons) or
whether they were broader and had an inflection (AINF-neuron) (Koerber and Mendell 1992 ; Amir and
Devor 1996 ; Villiere and McLachlan 1996 ). A circuit that calculated the
spike waveform derivative was used for this purpose.
Membrane potential was sampled at 5 kHz for 1-4 sec (pCLAMP v6.0.3,
Axon Instruments, Foster City, CA) and processed by fast Fourier
analysis (FFT) and autocorrelation using DataWave software (CP Analysis
v5.1). All mean values are given ± SD.
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RESULTS |
DRGs from intact animals
When first penetrated, most DRG neurons in young rats had a stable
resting potential. A minority, however, exhibited periodic, sinusoidal
membrane potential oscillations (9/73 A-neurons sampled, 12.3%), with
a mean frequency of 96 ± 18 Hz (range 78-127 Hz). Membrane
potential oscillations were usually sustained, but in some cells there
were intermittent brief pauses ( 100 msec). The small amplitude
of the oscillations at resting membrane potential (1.4 ± 0.6 mV
peak-to-peak), and their high frequency, may explain why they have not
been reported previously (also see Discussion). Once one is alerted to
their presence, the oscillations are readily distinguished in raw
recordings and documented using Fourier analysis or autocorrelation
(Fig. 1). The presence or absence of
oscillations in any given neuron was usually unequivocal. However, we
adopted as a formal criterion that amplitude peaks be at least 1.5×
the amplitude of the background noise level seen during brief pauses when present, and/or that there be a distinct peak in the FFT plot at
the frequency expected from visual inspection of the voltage trace.

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Figure 1.
Membrane potential oscillations recorded from DRG
A- and C-neurons. A, Subthreshold oscillations recorded
from an A0-neuron in an immature rat with nerves intact.
Oscillation amplitude was increased when the cell was depolarized from
rest (Vr) to 35 mV and subsequently
decreased with still deeper depolarization (left). This
neuron did not fire action potentials. The FFT profile in this cell
illustrates oscillation coherence and amplitude (power) peak (103 Hz)
at 35 mV and the increase in oscillation frequency with
depolarization (right). Power scale was normalized
relative to the maximal power recorded at 35 mV. The
inset shows the autocorrelogram at 35 mV.
B, Membrane oscillations recorded from a C-neuron in a
mature rat 15 d after sciatic injury. At 36 mV, oscillations
occasionally triggered action potentials [spike amplitude is truncated
(left)]. The FFT profile at different membrane
potentials in this cell, and its autocorrelogram
(inset), illustrates a dominant oscillation frequency of
20 Hz at 39 mV (right). The power scale was normalized
as in A.
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The resting potential of cells that had subthreshold oscillations on
initial electrode penetration was more depolarized, on average, than
that of cells without oscillations ( 49.4 ± 6.4 mV vs
60.5 ± 6.5 mV, p < 0.01). Correspondingly,
depolarization by intracellular current injection recruited
oscillations in some neurons in which they were not detected on initial
penetration (Fig. 1, Table 1) and reduced
the prevalence of silent pauses in cells that had oscillations at rest.
For example, measurements in five intermittent cells showed an increase
in the percentage of time oscillating from 68% at rest to 91% when
depolarized by 8 mV. Therefore, to assess whether a cell had
oscillatory capability, we routinely shifted the membrane potential in
the depolarizing direction until the appearance of oscillations as
defined above, or until the membrane potential reached 20 mV. With
use of this search protocol the number of A-neurons with oscillations
more than doubled from that seen at resting potential, and oscillations were revealed in C-neurons (Table 1).
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Table 1.
Prevalence (proportion of cells sampled) of subthreshold
membrane potential oscillations in DRG neurons from immature rats at
resting membrane potential and in the presence of depolarization
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Nearly all of the A-neurons that had subthreshold oscillations were of
the A0 type, i.e., they were A-neurons lacking an
inflection (Table 1). Oscillations were encountered in only one
AINF-neuron. In general,
A0-neurons tend to be low-threshold
mechanoreceptors, whereas AINF- and C-neurons
include many nociceptors (Koerber and Mendell, 1992 ).
Fourier analysis revealed that subthreshold oscillations in any given
neuron form a monotonic frequency peak, the cell's "dominant oscillation frequency." The dominant frequency gradually increased as
the cell was depolarized. As the frequency increased, the width of the
frequency power distribution narrowed and its height increased, reflecting a voltage-dependent increase in the amplitude and coherence of the oscillations (Fig. 1). With further depolarization, oscillation frequency continued to increase, but the amplitude declined until oscillations were no longer discernible. It was therefore possible to
define a "best oscillation frequency" at which the oscillation amplitude was maximal. Peak oscillation amplitude usually fell within
the range of 3-6 mV. Best frequency for
A0-neurons averaged 118 ± 26 Hz (88-195
Hz, n = 20) and for C-neurons 11.7 ± 2.9 (10-15 Hz, n = 3). Determination of these values was often
complicated by the appearance of spike discharge (see below).
To ascertain whether subthreshold oscillations are a peculiarity of
sensory neurons in young animals, we also looked at neurons in DRGs
taken from adult rats. Both A0- and C-neurons in
adults showed sinusoidal oscillations very similar to those seen in
young animals. The prevalence of A0-neurons with
subthreshold oscillations at rest or on depolarization was higher in
immature than in adult rats (35 vs 11%, p = 0.002)
(Tables 1, 3). In C-neurons, on the other hand, it was slightly higher
in adults, although the difference was not statistically significant
(25 vs 28%, p > 0.2). In all cases, the amplitude,
frequency, and prevalence of the oscillations were dependent on
membrane potential much as in immature animals. Best frequency for
A0-neurons in adults averaged 124 ± 44 Hz
(68-195 Hz, n = 6) and for C-neurons averaged 52 ± 35 (15-107 Hz, n = 6).
Repetitive spike discharge
In DRGs from both immature and adult rats, repetitive spike
discharge was rare at resting membrane potential. However, on injection
of depolarizing current, either by a step function or a slow ramp, a
significant proportion of the cells began to discharge repetitively
(Table 2;
2 p < 0.001).
Depolarization promoted spiking in two ways: it increased oscillation
amplitude, and it brought the neuron closer to spike threshold.
There was a striking relation between the presence of subthreshold
potential oscillations and repetitive firing. Only neurons that showed oscillations fired repetitively at rest or on
depolarization. Moreover, in all neurons that fired repetitively,
action potentials consistently emerged from the rising (depolarizing)
phase of oscillations. This indicates a causal relation between the
oscillations and spiking, not just a correlation (Figs.
1B, 2). The site of
spike initiation would appear to be close to the recording electrode, presumably at the axon hillock-initial segment portion of the cell
soma. Cells that did not show subthreshold oscillations never fired
repetitively, either spontaneously or on ramp depolarization (n = 165), and although some did fire a single spike or
a short burst of spikes at the beginning of a step depolarization, none generated discharge that lasted >200 msec, the criterion that we
adopted for "repetitive firing."

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Figure 2.
Spontaneous repetitive bursty discharge in a DRG
A0-neuron from an immature rat. Spikes are truncated except
in the inset at top, which shows one of
the bursts on a faster timebase. The interspike interval dot display
above each of the four spike bursts shown illustrates the gradual
deceleration of discharge during the course of the burst. A similar
firing pattern is seen in in vivo recordings of ectopic
burst discharge originating in the DRG. Segments of the record at time
points 1-4 are shown below on a still
faster timebase to illustrate the triggering of spike bursts by
membrane potential oscillations.
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Two patterns of repetitive discharge were observed in neurons with
oscillatory capability: slow and irregular (0.5-4 imp/sec), and bursty
(Table 2). In neurons that fired irregularly, single spikes occurred
when individual oscillations reached threshold. In bursting cells,
oscillations that reached threshold triggered a burst of high-frequency
spikes (interspike interval 4-15 msec). Bursts were usually terminated
by a burst-induced hyperpolarizing shift of the membrane potential
(Amir and Devor, 1997 ). After firing stopped, subthreshold oscillations
could once again be observed, but their amplitude was lower than it was
before the burst. As the hyperpolarizing shift faded the amplitude of
the oscillations increased. Eventually one oscillation reached
threshold and evoked a second burst of spikes, completing the burst
cycle (Fig. 2). The on-off duty cycle of bursts ranged from 0.02-1
sec on/0.05-4 sec off and varied with membrane potential. Both the bursty and the slow/irregular ectopic discharge pattern have been described previously in DRG neurons in vivo (Wall and Devor,
1983 ).
DRGs from nerve-injured animals
We next investigated the effect of previous nerve injury on
membrane potential oscillations and on the ectopic spike discharge that
they trigger. The sciatic nerve was transected in adult rats, and DRG
recordings were made 2-15 d later. This form of nerve injury is known
to induce both ongoing pain in the area of denervation, and allodynia
in the adjacent partially denervated territory (Wall et al., 1979 ;
Markus et al., 1984 ; Kingery and Vallin 1989 ). We found that nerve
injury induced a significant increase in the prevalence of DRG neurons
with subthreshold oscillations, at least in
A0-neurons (Table
3). The proportion of
A0-neurons with oscillations at rest or on
depolarization increased from 11 to 46% (p < 0.0002). In C-neurons the proportion increased from 28 to 44%,
although this difference did not reach statistical significance
(p > 0.2). As a consequence of the increased
incidence of oscillations, the incidence of repetitive spike discharge
also increased (Table 3).
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Table 3.
Effect of previous sciatic nerve injury on the proportion
of DRG neurons in adult rat DRGs that had membrane potential
oscillations and produced repetitive spike discharge (firing)
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Oscillatory mechanism
A voltage- and TTX-sensitive Na+
conductance(s) appears to contribute to the resonance characteristic
responsible for subthreshold membrane potential oscillations in DRG
neurons. As illustrated in Figure 3,
partial replacement of Na+ in the bath
solution with choline eliminated the oscillations (5/5
A0-cells tested), as did bath application of
either TTX (Sigma; 1 µM, 4/4
A0-cells tested, and 3/3 C-cells tested) or
lidocaine (Teva, Tel Aviv, Israel; 4 µM, 5/5
A0-cells tested, 1/1 C-cells tested). Once
eliminated in this way, oscillations could not be restored by further
depolarization, but they generally reappeared after washout of the
blocker (Fig. 3). At 1 µM, TTX effectively distinguishes
between TTX-sensitive and TTX-resistant
Na+ channels (Sangameswaran et al., 1996 ).
Bath-applied Co2+ (5 mM), a
wide-spectrum Ca2+ channel blocker, was
not effective at blocking the oscillations (up to 6 min).

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Figure 3.
Subthreshold membrane potential
oscillations, and resulting spike bursting, depend on voltage-sensitive
Na+ conductance. A illustrates a
period of subthreshold oscillations that lead up to a spike burst in an
A0-neuron from an adult rat whose ipsilateral sciatic nerve
had been cut 7 d previously (control).
Replacing NaCl in the bath solution with choline-Cl, thus reducing the
bath Na+ concentration from 151 to 27 mM, abolished the oscillations and the resulting spikes
within 2 min. They could not be restored by further depolarization.
Washout of choline and return to the control bath solution restored
both the oscillations and bursting within 17 min
(recovery). All three traces were recorded at 62 mV.
Top traces show (left) the
intracellularly recorded spike before, during, and after choline
application [at resting potential
(Vr) = 69 mV], and
(right) the simultaneously recorded DR compound action
potential. Both spike and compound action potential persisted, if with
a reduced amplitude, when oscillations and ectopic spiking were
eliminated. Propagation distance from the sciatic nerve stimulation
site was 37 mm to the cell soma and 50 mm to the compound action
potential recording electrode. B, In this
A0-neuron from an adult rat DRG, depolarization from rest
(Vr = 69 mV) to 57 mV yielded
subthreshold oscillations that triggered spike bursting
(control trace; spikes truncated). Bath application of 1 µM TTX abolished the oscillations and spikes within 2 min
(TTX 2'). Spike propagation in response to nerve stimulation
at a distance of 7 mm persisted at this time, although it failed 4 min
later (TTX 6'). Further depolarization failed to restore
oscillations or spiking, but TTX washout frequently did (data not
shown).
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Suppression of oscillations with Na+
substitution, TTX, or lidocaine always suppressed repetitive firing,
consistent with the idea of a causative relation between the
oscillations and the firing (8/8 discharging
A0-cells and 2/2 C-cells tested) (Fig. 3).
Interestingly, oscillations and consequent firing were consistently blocked at times when propagation of spikes evoked by axonal
stimulation persisted (Fig. 3). At high concentrations of lidocaine
(0.4-40 mM), spike propagation was blocked along with the
oscillations, but at low concentrations (4 µM),
oscillations were eliminated and spike propagation persisted (4/4
A0-neurons). The same occurred using
low-Na+ Krebs solution. In both cases
spike height was attenuated. TTX (1 µM) blocked
oscillations and repetitive spiking rapidly, and propagation only after
a delay. Ectopic firing in vivo is also suppressed using
lidocaine concentrations insufficient to block axon conduction (Devor
et al., 1992 ).
Potential electrical and mechanical artifacts
Various neuronal types in the CNS are known to have intrinsic
oscillatory properties (Llinas, 1988 ; Yarom, 1989 ; Alonzo and Klink,
1993 ; Puil et al., 1994 ; Gutfreund et al., 1995 ; Hutcheon et al.,
1996 ). However, we know of no previous reports of sustained oscillations in DRG somata despite the abundant attention these cells
have attracted. The main reason, as noted above, is probably the
relatively small proportion of neurons (in intact ganglia) that show
oscillations at resting membrane potential, and their small amplitude.
Nonetheless, it is prudent to consider the possibility that our
findings are the result of an electrical or mechanical artifact.
An explanation based on artifactual electrical pickup can be excluded
because the oscillation rate was not a multiple of the 50 Hz line
current, and frequency, amplitude, and coherence of oscillations were
voltage and drug sensitive. Moreover, their prevalence within a
particular ganglion depended on cell type and previous axotomy. We can
also rule out an error based on mechanical vibrations in the recording
system, both crude movement artifact and the more esoteric possibility
of vibration-evoked ionic currents attributable to coupling between
mechanosensitive channels and a TTX-sensitive
Na+ conductance. First, the recording
system was isolated from building vibrations by a high quality air
suspension table. Second, the oscillation frequency was sensitive to
membrane potential and varied from cell to cell within a ganglion (Fig.
1). Third, identical results were obtained using two separate
micromanipulator systems that had different inertial mass (~700 vs
1500 g) and hence different mechanical resonances. Fourth,
the intrinsic resonance frequency of our main
micromanipulator-microelectrode system, determined by dropping graded
weights on the table during the course of recording, was ~20 Hz, and
not ~100 Hz like the subthreshold oscillations. Moreover, the 20 Hz
oscillations generated in this way did not vary with cell type and
occurred even when the microelectrode was extracellular. Finally, there
is no obvious mechanism that would have immunized the authors of
previous studies of DRG neurons from artifacts caused by voltage- and
ligand-sensitive conductances coupled to putative mechanosensitive channels.
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DISCUSSION |
We have shown that some A0- and C-neurons in
rat DRGs display sinusoidal voltage-sensitive oscillations in their
membrane potential, that these oscillations give rise to action
potentials when they reach threshold, and that oscillations are an
essential requirement for the generation of sustained spike discharge
on steady-state or slow-ramp depolarization. Nerve injury increases the
prevalence of oscillations and consequently the intensity of ectopic
discharge originating in the DRG.
Although subthreshold oscillations and resonance have not been reported
previously in DRG neurons, they have been described in primary sensory
neurons in the trigeminal system. Pelkey and Marshall (1998) recently
reported sustained, high-frequency, voltage-sensitive oscillations in
some neurons of the mesencephalic nucleus of the trigeminal nerve
(MesV). Puil and coworkers (Puil et al., 1986 , 1988 , 1989 ; Puil and
Spigelman 1988 ) showed that trigeminal ganglion (TRG) neurons, when
stimulated with a sinusoidally varying constant current waveform, show
a voltage maximum at particular resonant frequencies. No spontaneous
subthreshold oscillations were seen, although transient damped
oscillations occurred during step depolarization. In both the MesV and
TRG, oscillatory behavior was usually between 100 and 180 Hz,
frequencies similar to those seen in DRG
A0-neurons.
Conductances involved in subthreshold oscillations
As in TRG neurons, oscillatory tendency in DRG neurons is probably
an intrinsic property of the neuron itself. The conductances thought to
underlie oscillations in brainstem, thalamic, and cortical neurons
(low-threshold Ca2+,
Ca2+-activated
K+, IQ,
IKS, and IH) are generally
too slow, and/or operate in voltage ranges too negative, to account for
the oscillatory behavior we saw in primary afferents (Llinas, 1988 ;
Yarom, 1989 ; Alonzo and Klink, 1993 ; Puil et al., 1994 ; Gutfreund et
al., 1995 ; Hutcheon et al., 1996 ). An interaction of voltage-sensitive
Na+ channels and
K+ or leak channels, as in the squid giant
axon (Guttman and Barnhill, 1972 ), is a more likely mechanism
(see below). Oscillatory behavior can also emerge from network
properties of functionally coupled neurons (Selverston, 1985 ; Getting,
1989 ; Yarom, 1989 ). Although DRGs are essentially devoid of synaptic
interconnections, DRG cells are weakly coupled by extracellular
K+ and diffusible chemical mediators
(Utzschneider et al., 1992 ; Amir and Devor, 1996 ). However, these
nonsynaptic coupling processes are too sluggish to account for the
high-frequency oscillations of DRG neurons.
The experiments using ion substitution and pharmacological blockers
suggest a central role for one or more TTX- and lidocaine-sensitive Na+ channels in the generation of the
depolarizing limb of subthreshold oscillations. The repolarizing limb
is probably caused by an outward K+ or
leak conductance (Llinas, 1988 ). For example, Hudspeth and collaborators (Roberts et al., 1988 ) have identified a
large-conductance Ca2+-activated
K+ channel (KCa) as
essential for the repolarizing phase of subthreshold oscillations in
cochlear hair cells. In studies to be reported elsewhere, we applied
the K+ channel blockers 4-aminopyridine
(Sigma; 1.0 mM) or tetraethyl ammonium extracellularly
(Sigma; 10 mM) or Cs2+
intracellularly. However, this did not eliminate the oscillations. Indeed, these blockers augmented oscillatory behavior and induced ectopic spiking, consistent with their excitatory effect in
vivo (Devor 1983 ). Ca2+ channel
blockers also appear to be ineffective [see Results and Matzner and
Devor (1994) ]. We tentatively conclude that in the DRG the inward
depolarizing TTX-sensitive Na+ current
interacts with a nonspecific repolarizing leak conductance to generate
oscillations. DRG neurons are highly heterogeneous in the spectrum of
ion channels that they express. The ultimate explanation of why
A0-neurons are oscillatory and
AINF-neurons generally are not is presumably
related to this heterogeneity, and likewise for the striking
differences between oscillations in A0- and
C-neurons. Further studies will be required to determine the specific
combination of biophysical characteristics responsible for oscillatory
behavior in particular subtypes of DRG neurons.
Increased oscillatory tendency after nerve injury
Increased Na+ conductance, caused by
nerve injury-induced changes in the vectorial transport of
Na+ channels and/or
Na+ channel upregulation, is implicated as
a factor in the generation of neuropathic afferent discharge in animals
and humans (Devor et al., 1994b ; Matzner and Devor, 1994 ; Chaplan et
al., 1995 ; England et al., 1996 ). The present results suggest that an
underlying cause of this hyperexcitability is the enhanced oscillatory
tendency of axotomized DRG neurons. The specific
Na+ conductance(s) involved is not known
for certain. One likely candidate is the sustained TTX-sensitive
Na+ conductance (Rizzo et al., 1994 ; Baker
and Bostock, 1997 ). This is partially activated at resting membrane
potential in rat DRG neurons, is enhanced by modest depolarization, and
is sensitive to Na+ ion substitution, TTX,
and lidocaine. Another possibility is the sustained window current
("m-h current") generated when the activation and inactivation
functions of certain transient Na+
conductances overlap in the voltage range that supports oscillatory behavior (Rizzo et al., 1996 ). A third candidate is the TTX-sensitive type III Na+ channel. This channel is
virtually absent in intact DRG neurons in adult rats and hence is
presumably not essential for baseline resonance. However, it may play a
role in neuropathy because it is dramatically upregulated and its
repriming kinetics are enhanced after axotomy (Waxman et al., 1994 ;
Cummins and Waxman, 1997 ). It is not unlikely that the electrical
phenotype of DRG neurons, and changes after axotomy, involve a
combination of these channels.
The TTX-resistant Na+ channels PN3/SNS and
NaN/SNS2 are thought to play a special role in neuropathic pain because
they are expressed selectively in DRG C-neurons (Akopian et al., 1996 ; Sangameswaran et al., 1996 ; Dib-Hajj et al., 1998 ; Tate et al., 1999 ). However, these transcripts are downregulated after nerve injury
(Dib-Hajj et al., 1996 , 1998 ; Cummins and Waxman, 1997 ), just as the
excitability of the C-neurons is increased. Moreover, we found that TTX
(1 µM) blocked subthreshold oscillations and spiking in
C-neurons. It should be noted, however, that C-neurons also express
TTX-sensitive Na+ channel types.
TTX-sensitive and TTX-resistant Na+
currents summate, determining nociceptor excitability jointly. Therefore, it is entirely possible that a selective PN3/SNS or NaN/SNS2
antagonist, if one could be developed, would suppress oscillations and
ectopic discharge in C-neurons. Such an agent might prove to be a
uniquely useful pain reliever if it indeed acted selectively in the
peripheral nerve and were devoid of side effects associated with
blockage of CNS, muscle, and cardiac Na+ channels.
Oscillations and repetitive discharge in injured axons
We recorded from afferent neuron somata. However, the behavior of
the DRG soma is often mirrored, at least in part, in the behavior of
the axon end (Reeh and Wadell, 1990 ; Harper, 1991 ). Consistent
with this, ectopic discharge generated in nerve end neuromas takes the
same patterns as that generated in DRG somata and is likewise
selectively blocked by low concentrations of TTX and lidocaine (Devor
et al., 1992 ; Matzner and Devor, 1994 ). It is therefore possible that
ectopic neuroma firing is also subserved by membrane potential
oscillations associated with a TTX-sensitive Na+ conductance. Indeed, Kapoor et al.
(1997) demonstrated that ectopic firing originating in primary afferent
axons at sites of demyelination is triggered by intrinsic TTX-sensitive
membrane potential oscillations. Oscillatory membrane properties may be
a general characteristic of afferent neurons capable of sustained
discharge, both injured axons and the peripheral receptor ending of
intact slowly adapting afferent types.
Relation of subthreshold oscillations to neuropathic pain
Because DRG neurons rarely fire at resting membrane potential and
the DRG is essentially devoid of synaptic input, what could induce the
depolarizing shift required to enhance oscillations and trigger ectopic
discharge, paraesthesias, and pain? In fact, there are a number of
nonsynaptic processes capable of doing this. Probably the most
important is the biomechanical strain delivered to sensory neurons
during movement or straight-leg lifting (Wall and Devor, 1983 ; Nordin
et al., 1984 ; Kuslich et al., 1991 ). In addition, cross-depolarization
induced in DRG neurons by spike activity in their neighbors can induce
ectopic spiking (Devor and Wall, 1990 ; Amir and Devor, 1996 ), as
can adrenergic agonists and sympathetic efferent activity (Devor et
al., 1994a ; Petersen et al., 1996 ). Indeed, we have preliminary
evidence that the discharge evoked by these conditions is caused by the
triggering or enhancement of oscillations. Slow, tonic depolarizing
factors lead to the generation of repetitive discharge only in neurons
that are primed for repetitive firing by virtue of their intrinsic
oscillatory characteristics. Nerve pathology appears to increase
ectopic firing primarily by enhancing oscillations. Oscillatory
behavior in afferent neurons can be thought of as a motor
ready to be engaged when the clutch of a slow-onset
physiological depolarization is released. Mechanical stress,
cross-depolarization, and sympathetic activity are all associated
clinically with the exacerbation of neuropathic sensory symptoms
(Sunderland, 1978 ; Bonica, 1990 ; Rappaport and Devor, 1994 ).
Axotomy induced an increase in the oscillatory behavior and spike
discharge of both A0 and C-neurons, although the
change in C-neurons did not reach statistical significance. However, even if the putative effect in C-neurons were discounted, the increased
excitability of A0-neurons can account not only
for neuropathic paraesthesias and dysaesthesias but also for frank pain. The low level ectopic C-fiber barrage generated in neuromas and
axotomized DRGs is believed to be sufficient to trigger and maintain
central sensitization. In the presence of central sensitization, input
on large diameter myelinated afferents, notably
A0-neurons, can generate pain sensation (Gracely
et al., 1992 ; Torebjork et al., 1992 ; Sheen and Chung, 1993 ). Several
additional processes triggered by nerve injury are also believed to be
capable of rendering spike activity in A0-neurons
painful. These include spinal disinhibition and the sprouting of
low-threshold afferent endings into superficial layers of the dorsal
horn (Devor 1988 ; Woolf et al., 1992 ). It should make no difference
whether this A0 activity originates in intact
cutaneous sensory endings or ectopically in the DRG. Our observations,
therefore, implicate the oscillatory behavior of primary afferent
neurons as a fundamental factor in the generation of ectopic afferent
firing and hence in the development of neuropathic pain states.
Correspondingly, the oscillatory mechanism may provide targets for
development of novel drugs for the treatment of chronic neuropathic pain.
 |
FOOTNOTES |
Received April 27, 1999; revised June 11, 1999; accepted July 12, 1999.
This work was supported by the United States-Israel Binational Science
Foundation (BSF), the German-Israel Foundation for Research and
Development (GIF), and the Leopold, Norman and Sara Yisraeli Memorial
Fund. M.M. received a Heisenberg fellowship from the Deutsche
Forschungsgemeinschaft. We thank B. Hutcheon for helpful comments on
this manuscript.
Correspondence should be addressed to Professor Marshall Devor,
Department of Cell and Animal Biology, Institute of Life Sciences, Hebrew University of Jerusalem, Jerusalem 91904, Israel.
 |
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A. Oda, H. Ohashi, S. Komori, H. Iida, and S. Dohi
Characteristics of Ropivacaine Block of Na+ Channels in Rat Dorsal Root Ganglion Neurons
Anesth. Analg.,
October 1, 2000;
91(5):
1213 - 1220.
[Abstract]
[Full Text]
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C.-N. Liu, M. Michaelis, R. Amir, and M. Devor
Spinal Nerve Injury Enhances Subthreshold Membrane Potential Oscillations in DRG Neurons: Relation to Neuropathic Pain
J Neurophysiol,
July 1, 2000;
84(1):
205 - 215.
[Abstract]
[Full Text]
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G. Boehmer, W. Greffrath, E. Martin, and S. Hermann
Subthreshold oscillation of the membrane potential in magnocellular neurones of the rat supraoptic nucleus
J. Physiol.,
July 1, 2000;
526(1):
115 - 128.
[Abstract]
[Full Text]
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M. Michaelis, X. Liu, and W. Janig
Axotomized and Intact Muscle Afferents But No Skin Afferents Develop Ongoing Discharges of Dorsal Root Ganglion Origin after Peripheral Nerve Lesion
J. Neurosci.,
April 1, 2000;
20(7):
2742 - 2748.
[Abstract]
[Full Text]
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