scholarly journals Harnessing the power of gate control: interventions for procedural pain and anxiety

2022 ◽  
Vol 9 (1) ◽  
pp. 55
Author(s):  
Carmelina D'Arro
Keyword(s):  
Control Theory ◽  
Procedural Pain ◽  
Top Down ◽  
Bottom Up ◽  
Gate Control Theory ◽  
Pain Transmission ◽  
Dental Procedures ◽  
Gate Control ◽  
Dental Setting ◽  
Pain Stimuli

Medical and dental procedures present a minefield of opportunities for pain and anxiety. Many procedures for diagnosis, treatment, and palliation are performed either without comfort measures at all or with sedation/anesthesia. Yet, there are many ways of decreasing patients’ procedural pain and anxiety and of increasing physical and psychological comfort. Gate control theory explains how we can close the gate on pain transmission (and minimize opening the gate) through non-pharmacological means. An exploration of several bottom-up and top-down interventions will be discussed including breathing, mindfulness, gradual exposure, non-pain stimuli, distraction, touch, and postoperative communications. Interventions will be illustrated with pictures and short videos in the dental setting.

Gate control theory and beyond

Pain Forum ◽  
1996 ◽  
Vol 5 (1) ◽  
pp. 40-44 ◽  
Author(s):  
Robert C. Coghill
Keyword(s):  
Control Theory ◽  
Gate Control Theory ◽  
Gate Control

Spinal cord stimulation

2010 ◽  
pp. 161-169
Author(s):  
Brian A. Simpson
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Control Theory ◽  
Spinal Cord Stimulation ◽  
Gate Control Theory ◽  
Relieve Pain ◽  
Gate Control ◽  
The 1960S

Electricity has been used for centuries to relieve pain but spinal cord stimulation (SCS) came about with the Gate Control Theory in the 1960s SCS was originally thought simply to close the gate by activating A fibres but its effect is more complex. It is likely that it helps to normalize the dysfunction that manifests as neuropathic pain...

scholarly journals Spinal sensory projection neuron responses to spinal cord stimulation are mediated by circuits beyond gate control

2015 ◽  
Vol 114 (1) ◽  
pp. 284-300 ◽  
Author(s):  
Tianhe C. Zhang ◽  
John J. Janik ◽  
Ryan V. Peters ◽  
Gang Chen ◽  
Ru-Rong Ji ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Control Theory ◽  
Spinal Cord Stimulation ◽  
Projection Neuron ◽  
Control Circuit ◽  
Neuron Activity ◽  
Projection Neurons ◽  
Intractable Pain ◽  
Gate Control Theory ◽  
Gate Control

Spinal cord stimulation (SCS) is a therapy used to treat intractable pain with a putative mechanism of action based on the Gate Control Theory. We hypothesized that sensory projection neuron responses to SCS would follow a single stereotyped response curve as a function of SCS frequency, as predicted by the Gate Control circuit. We recorded the responses of antidromically identified sensory projection neurons in the lumbar spinal cord during 1- to 150-Hz SCS in both healthy rats and neuropathic rats following chronic constriction injury (CCI). The relationship between SCS frequency and projection neuron activity predicted by the Gate Control circuit accounted for a subset of neuronal responses to SCS but could not account for the full range of observed responses. Heterogeneous responses were classifiable into three additional groups and were reproduced using computational models of spinal microcircuits representing other interactions between nociceptive and nonnociceptive sensory inputs. Intrathecal administration of bicuculline, a GABAA receptor antagonist, increased spontaneous and evoked activity in projection neurons, enhanced excitatory responses to SCS, and reduced inhibitory responses to SCS, suggesting that GABAA neurotransmission plays a broad role in regulating projection neuron activity. These in vivo and computational results challenge the Gate Control Theory as the only mechanism underlying SCS and refine our understanding of the effects of SCS on spinal sensory neurons within the framework of contemporary understanding of dorsal horn circuitry.

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