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Spinal cord stimulation modulates cerebral neurobiology: a proton magnetic resonance spectroscopy study

  • Functional Neuroradiology
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Abstract

Introduction

Although spinal cord stimulation (SCS) is a widely used treatment for chronic neuropathic pain secondary to spinal surgery, little is known about the underlying physiological mechanisms.

Methods

The primary aim of this study is to investigate the neural substrate underlying short-term SCS by means of 1H MR spectroscopy with short echo time, in 20 patients with failed back surgery syndrome.

Results

Marked increase of γ-aminobutyric acid (GABA) and decrease in glucose in the ipsilateral thalamus were found between baseline situation without SCS and after 9′ of SCS, indicating the key role of the ipsilateral thalamus as a mediator of chronic neuropathic pain. In addition, this study also showed a progressive decrease in glucose in the ipsilateral thalamus over time, which is in line with the findings of previous studies reporting deactivation in the ipsilateral thalamic region.

Conclusions

The observation of GABA increase and glucose decrease over time in the ipsilateral thalamus may be the causal mechanism of the pain relief due to SCS or an epiphenomenon.

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Acknowledgments

We thank Ursule Van de Velde and Cindy Tettelin for their help in data management.

Conflict of interest

MM is a clinical investigator of The Research Foundation Flanders (FWO) and received the Lyrica Independent Investigator Research Award (LIIRA); he has received consultancy or speaker honoraria from Medtronic and Pfizer. RB has received consultancy or speaker honoraria from Pfizer, Medtronic, Shire Human Genetics Therapies, Sanofi-Aventis and Bayer. BN has received grants for research, education, and travel from Medtronic Inc, and holds a Chair for Neurosurgery for Psychiatric Disorders, funded by a donation from Medtronic Inc.; he has received grants from OT, FWO, IWT-3WIN, and SBO.

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Authors and Affiliations

  1. Department of Neurosurgery and Center for Neuroscience, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Maarten Moens

  2. Department of Neurology, ZNA Middelheim General Hospital, Lindendreef 1, 2020, Antwerp, Belgium

    Peter Mariën

  3. Department of Clinical and Experimental Neurolinguistics, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium

    Peter Mariën

  4. Neurology and Center for Neuroscience, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Raf Brouns & Ann De Smedt

  5. Anesthesiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Jan Poelaert

  6. Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium

    Ronald Buyl

  7. Cardiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Steven Droogmans

  8. Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Peter Van Schuerbeek

  9. Department of Radiology, UZ Leuven, Katholieke Universiteit Leuven, Herestraat 49, 3000, Leuven, Belgium

    Stefan Sunaert

  10. Neurosurgery, UZ Leuven, Katholieke Universiteit Leuven, Herestraat 49, 3000, Leuven, Belgium

    Bart Nuttin

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  1. Maarten Moens
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Correspondence to Maarten Moens.

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Moens, M., Mariën, P., Brouns, R. et al. Spinal cord stimulation modulates cerebral neurobiology: a proton magnetic resonance spectroscopy study. Neuroradiology 55, 1039–1047 (2013). https://doi.org/10.1007/s00234-013-1200-7

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  • DOI: https://doi.org/10.1007/s00234-013-1200-7

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