Electroacupuntura y neuromodulación en la médula espinal: implicaciones en el dolor neuropático

Neuromodulation by electrical stimulation of the nervous system constitutes a novel therapeutic strategy in the treatment of pain. It has been shown that electroacupuncture (EA) may activate afferent fibres in a similar manner to direct electrical stimulation of peripheral nerves. The difference is that EA is a percutaneous stimulation using needles, and is less invasive than the surgery required for the implantation of electrodes in the peripheral nerves. In neuropathic pain models, it has been shown that EA modulates multiple interconnected systems in the body. At the level of the spinal cord, EA activates serotonergic, adrenergic, cholinergic, and opioid pathways, as well as presynaptic mechanisms associated with primary afferent depolarisation. It has also been shown that EA effects extend to neuroglia. The characterisation of EA parameters as intensity, frequency, and duration of pulses is essential for the induction of neuromodulation of synaptic transmission at the spinal cord level, and consequently, it could be used for the development of optimal therapeutic actions in pain treatment.