Abstract
The analgesic efficacy of cortical stimulation on refractory neuropathic pain has been established. Although it offers pain relief to 45–75% of the patients, this technique remains under evaluation and the definitive protocol for its application has not been established yet. The mechanisms underlying the analgesic efficacy of cortical stimulation are still largely unknown. Successive technical adaptations have been proposed and tried in order to reduce the number of non-responding patients. In this chapter, we summarize the limited amount of crucial information that has been acquired so far on pain processing in the central nervous system, on the functional pathophysiology of neuropathic pain and on the mechanisms underlying the efficacy of cortical stimulation. We also discuss key issues that could help to increase the success rate and enhance the future prospects of the technique.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Carroll D, Joint C, Maartens N, Shlugman D, Stein J, Aziz TZ (2000) Motor cortex stimulation for chronic neuropathic pain: a preliminary study of 10 cases. Pain 84: 431–437
Casey KL (2000) Concepts of pain mechanisms: the contribution of functional imaging of the human brain. Prog Brain Res 129: 277–287
Di Lazzaro V, Oliviero A, Profice P, Insola A, Mazzone P, Tonali P, Rothwell JC (1999) Direct demonstration of interhemispheric inhibition of the human motor cortex produced by transcranial magnetic stimulation. Exp Brain Res 124: 520–524
Duffau H (2001) Acute functional reorganisation of the human motor cortex during resection of central lesions: a study using intraoperative brain mapping. J Neurol Neurosurg Psychiatry 70: 506–513
Ebel H, Rust D, Tronnier V, Boker D, Kunze S (1996) Chronic precentral stimulation in trigeminal neuropathic pain. Acta Neurochir (Wien) 138: 1300–1306
Ferretti A, Del Gratta C, Babiloni C, Caulo M, Arienzo D, Tartaro A, Rossini PM, Romani GL (2004) Functional topography of the secondary somatosensory cortex for nonpainful and painful stimulation of median and tibial nerve: an fMRI study. Neuroimage 23: 1217–1225
Garcia-Larrea L, Peyron R, Mertens P, Grégoire MC, Lavenne F, Le Bars D, Convers P, Mauguière F, Sindou M, Laurent B (1999) Electrical stimulation of motor cortex for pain control: a combined PET-scan and electrophysiological study. Pain 83: 259–273
Helmchen C, Lindig M, Petersen D, Tronnier V (2002) Disappearance of central thalamic pain syndrome after contralateral parietal lobe lesion: implications for therapeutic brain stimulation. Pain 98: 325–330
Herregodts P, Stadnik T, De Ridder F, D’Haens J (1995) Cortical stimulation for central neuropathic pain: 3-D surface MRI for easy determination of the motor cortex. Acta Neurochir Suppl 64: 132–135
Karl A, Birbaumer N, Lutzenberger W, Cohen LG, Flor H (2001) Reorganization of motor and somatosensory cortex in upper extremity amputees with phantom limb pain. J Neurosci 21: 3609–3618
Katayama Y, Fukaya C, Yamamoto T (1998) Poststroke pain control by chronic motor cortex stimulation: neurological characteristics predicting a favorable response. J Neurosurg 89: 585–591
Laterre EC, De Volder AG, Goffinet AM (1988) Brain glucose metabolism in thalamic syndrome. J Neurol Neurosurg Psychiatry 51: 427–428
Lee L, Siebner HR, Rowe JB, Rizzo V, Rothwell JC, Frackowiak RSJ, Friston KJ (2003) Acute remapping within the motor system induced by low-frequency repetitive transcranial magnetic stimulation. J Neurosci 23: 5308–5318
McCarthy G, Alisson T, Spencer DD (1993) Localization of the face area of human sensorimotor cortex by intracranial recording of somatosensory evoked potentials. J Neurosurg 79: 874–884
Meyerson BA, Lindblom U, Linderoth B, Lind G, Herregodts P (1993) Motor cortex stimulation as treatment of trigeminal neuropathic pain. Acta Neurochir Suppl 58: 150–153
Migita K, Uozumi T, Arita K, Monden S, Lindblom U, Linderoth B (1995) Transcranial magnetic coil stimulation of motor cortex in patients with central pain. Neurosurgery 36: 1037–1040
Nguyen JP, Lefaucheur JP, Decq P, Uchiyama T, Carpentier A, Fontaine D, Brugieres P, Pollin B, Feve A, Rostaing S, Cesaro P, Keravel Y (1999) Chronic motor cortex stimulation in the treatment of central and neuropathic pain. Correlations between clinical, electrophysiological and anatomical data. Pain 82: 245–251
Pirotte B, Voordecker P, Neugroschl C, Baleriaux D, Wikler D, Metens T, Denolin V, Joffroy A, Massager N, Brotchi J, Levivier M (2005) Combination of functional MR-guided neuronavigation and intraoperative cortical brain mapping improves targeting of motor cortex stimulation in neuropathic pain. Neurosurgery 2Suppl 56: 344–359
Pirotte B, Neugroschl C, Metens T, Wikler D, Denolin V, Voordecker P, Joffroy A, Massager N, Brotchi J, Levivier M, Baleriaux D (2005) Comparison of functional MRI-guidance to electrical cortical mapping for targeting selective motor cortex areas in neuropathic pain: a study based on intraoperative stereotactic navigation. AJNR Am J Neuroradiol (in press)
Roux FE, Ibarrola D, Tremoulet M, Lazorthes Y, Henry P, Sol JC, Berry I (2001) Methodological and technical issues for integrating functional magnetic resonance imaging data in a neuronavigational system. Neurosurgery 49: 1145–1156
Saitoh Y, Osaki Y, Nishimura H, Hirano S, Kato A, Hashikawa K, Hatazawa J, Yoshimine T (2004) Increased regional cerebral blood flow in the contrealateral thalamus after successful motor cortex stimulation in a patient with poststroke pain. J Neurosurg 100: 935–939
Seghier ML, Lazeyras F, Vuilleumier P, Schnider A, Carota A (2005) Functional magnetic resonance imaging and diffusion tensor imaging in a case of central poststroke pain. J Pain 6: 208–212
Torquati K, Pizzella V, Babiloni C, Del Gratta C, Della Penna S, Ferretti A, Franciotti R, Rossini PM, Romani GL (2005) Nociceptive and non-nociceptive sub-regions in the human secondary somatosensory cortex: an MEG study using fMRI constraints. Neuroimage 26: 48–56
Tran TD, Hoshiyama M, Inui K, Kakigi R (2003) Electrical-induced pain diminishes somatosensory evoked magnetic cortical fields. Clin Neurophysiol 114: 1704–1714
Tsubokawa T, Katayama Y, Yamamoto T, Hirayama T, Koyama S (1993) Chronic motor cortex stimulation in patients with thalamic pain. J Neurosurg 78: 393–401
Wood CC, Spencer DD, Alisson T, McCarthy G, Williamson PD, Goff WR (1988) Localization of human sensorimotor cortex during surgery by cortical surface recording of somatosensory evoked potentials. J Neurosurg 68: 99–111
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Springer-Verlag
About this chapter
Cite this chapter
Pirotte, B., Voordecker, P., Brotchi, J., Levivier, M. (2007). Anatomical and physiological basis, clinical and surgical considerations, mechanisms underlying efficacy and future prospects of cortical stimulation for pain. In: Sakas, D.E., Simpson, B.A. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/2. Springer, Vienna. https://doi.org/10.1007/978-3-211-33081-4_10
Download citation
DOI: https://doi.org/10.1007/978-3-211-33081-4_10
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-33080-7
Online ISBN: 978-3-211-33081-4
eBook Packages: MedicineMedicine (R0)