Modulation of signal transduction gene expression following pulsed radiofrequency in dorsal root ganglia and pregabalin therapy

Introduction: A randomized controlled study was conducted to assess modulation of signal transduction genes (PKA, PKC and ERK) following integrated multimodal approach encompassing pulsed radiofrequency treatment (PRF) of dorsal root ganglion and pregabalin in thoracic postherpetic neuralgia (PHN). Clinical variables such as pain intensity and quality of life were also explored. Material & methods: A total of 40 Patients of PHN were recruited. 20 patients randomly assigned to each of the two groups, group PP administered PRF with pregabalin and group SP administered pregabalin alone. Results: Significant downregulation of PKA and ERK observed in group PP at end of 10th week (p < 0.05). A significantly positive correlation demonstrated between Visual analog scale scores and signal transduction genes expression in PHN patients. Conclusion: Downregulation of all three signal transduction genes was observed following the integrated multimodal approach; however, significant downregulation was observed with PKA and ERK only. A positive correlation observed between signal transduction gene expression and visual analog scale scores signify their role in the pathogenesis of PHN. Lay abstract: People who had nerve pain after recovering from a herpes attack (postherpetic neuralgia) were treated with pulsed radiofrequency (PRF) treatment of the dorsal root ganglion, which involves stimulating a nerve cluster at the base of the spine with radio waves, along with oral pregabalin therapy, or with pregabalin alone. Certain pain genes such PKA, PKC and ERK were found to be suppressed after the combined treatment with PRF and pregabalin. The suppression of these genes was also associated with the self-reported pain scores of the participants in the study. Tweetable abstract: Downregulation of mRNA expression of PKA and ERK genes, which may play a part in chronic pain pathogenesis, was observed following treatment consisting of pulsed radiofrequency treatment of dorsal root ganglion + pregabalin compared with pregabalin only.