Motor cortex stimulation for deafferentation pain

Neurosurgical Focus
Youichi SaitohToshiki Yoshimine

Abstract

The authors tested a modified motor cortex stimulation (MCS) protocol for the treatment of deafferentation pain in 15 patients: eight patients with poststroke pain, four with brachial plexus injury, two with phantom limb pain, and one with spinal cord injury. Preoperative pharmacological tests were performed with phentolamine, lidocaine, ketamine, thiopental, morphine, and a placebo. In 12 patients we placed a 20- or 40-grid electrode in the subdural space to determine the best stimulation point for pain relief over a few weeks and therefore the optimum position for a permanent internal device. In four patients, the MCS devices were implanted in the interhemispheric fissure to reduce lower-extremity pain. In one patient, the MCS device was placed within the central sulcus, and a 20-grid electrode was placed on the brain surface. In two patients with pain extending from the upper extremity to the hyperbody, dual-electrode devices were implanted to drive two electrodes. In 10 of the 15 patients MCS-induced pain reduction was achieved (four with excellent, two with good, and four with fair alleviation of pain). The result of pharmacological testing indicated that patients with ketamine sensitivity seem to be good candidates for MC...Continue Reading

References

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Citations

Mar 10, 2009·Current Neurology and Neuroscience Reports·Laneshia ThomasKendall H Lee
Jan 1, 2008·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Jeffrey E Arle, Jay L Shils
Jan 1, 2010·Neuromodulation : Journal of the International Neuromodulation Society·Jaimie M HendersonRobert S Fisher
Mar 8, 2007·Neurosurgical Focus·Jaimie M Henderson, Shivanand P Lad
Jan 5, 2008·Journal of Neurosurgery·Daniel YoshorJohn H R Maunsell
Jul 2, 2008·Journal of Neurosurgery·Jeffrey E ArleJay L Shils
Dec 12, 2012·Surgical Neurology International·Guillermo A Monsalve
Sep 23, 2014·Neurosurgery Clinics of North America·Thomas OstergardJonathan P Miller
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Nov 15, 2014·Neuromodulation : Journal of the International Neuromodulation Society·Timothy DeerRobert Levy
Jun 27, 2014·Neuromodulation : Journal of the International Neuromodulation Society·Robert M Levy
Sep 21, 2011·Nature Reviews. Neurology·Jean-Paul NguyenJean-Pascal Lefaucheur
May 31, 2007·Stereotactic and Functional Neurosurgery·A MachadoJ M Henderson
Oct 1, 2008·Neurosurgery·Nathan J RanalliEric L Zager
Oct 23, 2015·Scientific Reports·Po-Chun ChuYu-Cheng Pei
Jan 19, 2013·The Clinical Journal of Pain·Collin ClarkeThomas Buchheit
Jun 15, 2021·Frontiers in Human Neuroscience·Wei ZhangJianguo Zhang

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