title: The Dorsal Root Ganglion as a Therapeutic Target for Chronic Pain.
abstract: Chronic neuropathic pain is a widespread problem with negative personal and societal consequences. Despite considerable clinical neuroscience research, the goal of developing effective, reliable, and durable treatments has remained elusive. The critical role played by the dorsal root ganglion (DRG) in the induction and maintenance of chronic pain has been largely overlooked in these efforts, however. It may be that, by targeting this site, robust new options for pain management will be revealed. This review summarizes recent advances in the knowledge base for DRG-targeted treatments for neuropathic pain:• Pharmacological options including the chemical targeting of voltage-dependent calcium channels, transient receptor potential channels, neurotrophin production, potentiation of opioid transduction pathways, and excitatory glutamate receptors.• Ablation or modulation of the DRG via continuous thermal radiofrequency and pulsed radiofrequency treatments.• Implanted electrical neurostimulator technologies.• Interventions involving the modification of DRG cellular function at the genetic level by using viral vectors and gene silencing methods.
authors.affiliation: From the *Department of Anesthesiology, Intensive Care and Pain Management, St Antonius Ziekenhuis, Nieuwegein; †Pain Treatment and Research Centre, Erasmus MC University Hospital, Rotterdam, the Netherlands; ‡Premier Pain Centers, NJ; and §Spinal Modulation, Menlo Park, CA.
authors.forename: Liong
authors.initials: L
authors.lastname: Liem
authors.forename: Eric
authors.initials: E
authors.lastname: van Dongen
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Huygen
authors.forename: Peter
authors.initials: P
authors.lastname: Staats
authors.forename: Jeff
authors.initials: J
authors.lastname: Kramer
mesh_terms: D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000818:Animals; D017115:Catheter Ablation / Q000009:adverse effects; D059350:Chronic Pain / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D003714:Denervation / Q000009:adverse effects / Q000379:methods*; D004599:Electric Stimulation Therapy / Q000295:instrumentation; D005727:Ganglia, Spinal / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery; D015316:Genetic Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D058542:Implantable Neurostimulators; D009437:Neuralgia / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D058748:Pain Perception; D017288:Pain Threshold; D016896:Treatment Outcome
chemical_list: D000700:Analgesics