GABAA receptor modulation in dorsal root ganglia in vivo affects chronic pain after nerve injury.

Neuropathic pain (NPP) due to sensory nerve injury is, in part, the result of peripheral sensitization leading to a long-lasting increase in synaptic plasticity in the spinal dorsal horn. Thus, activation of GABA-mediated inhibitory inputs from sensory neurons could be beneficial in the alleviation of NPP symptoms. Dorsal root ganglia (DRG) conduct painful stimulation from the periphery to the spinal cord. Long-lasting down-regulation in GABA tone or sensitivity in DRG neurons has been reported in animals with neuropathy. To determine the function of GABA in DRG in the development of NPP, we examined how the acute pharmacological GABA(A)-receptor modulation of L5 DRG in vivo affects the development of NPP in rats with crush injury to the sciatic nerve. Direct application of muscimol and gaboxadol, GABA(A) agonists, to L5 DRG immediately after injury induced dose-dependent alleviation, whereas bicuculline and picrotoxin, GABA(A) antagonists, worsened NPP postaxonal injury. The pain-alleviating effects of muscimol and gaboxadol were blocked by bicuculline. Muscimol, applied at the time of injury, caused complete and long-lasting abolishment of NPP development. However, when muscimol was applied after NPP had already developed, its pain-alleviating effect, although significant, was short-lived. Using a fluorescent tracer, sodium fluorescein, we confirmed that local DRG application results in minimal spread into the corresponding dorsal horn of the ipsilateral spinal cord. GABA(A) receptors in DRG are important in the development of NPP after peripheral nerve injury, making timely exogenous GABAergic manipulation at the DRG level a potentially useful therapeutic modality.