Treatment of chronic neuropathic pain by motor cortex stimulation: results of a bicentric controlled crossover trial

Brain Stimulation
Jean-Paul NguyenJean-Pascal Lefaucheur

Abstract

Chronic motor cortex stimulation (MCS) with surgically implanted epidural electrodes has been proposed as a treatment for neuropathic pain refractory compared with medical treatment. However, no prospective controlled trial has been published to provide convincing evidence of MCS analgesic efficacy. To compare MCS analgesic efficacy between "ON"- and "OFF"-stimulation conditions in a double-blinded crossover trial. Ten patients with chronic neuropathic pain of either peripheral or central origin underwent MCS implantation in two centers (Créteil, France, and Mexico City, Mexico). At the end of the second postoperative month, patients were randomly assigned into two groups. In the first group, the stimulator was switched "OFF" for two weeks and then was switched "ON" for the next 2 weeks. The opposite sequence was applied in the second group. Preoperative and postoperative assessment (until 1 year after surgery) was performed using visual analogue scale (VAS), verbal scale (VS), Wisconsin brief pain questionnaire (WBPQ), McGill pain questionnaire (MPQ), McGill quality of life scale, and medication quantification scale. During the crossover trial, VAS, VS, WBPQ, and MPQ scores were significantly reduced in the"ON"- compared with ...Continue Reading

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