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Biochemistry of Pain Relief with Intracerebral Stimulation

Few Facts and Many Hypotheses

  • Conference paper
Advances in Stereotactic and Functional Neurosurgery 4

Part of the book series: Acta Neurochirurgica Supplementum ((STEREOTACTIC,volume 30))

Summary

On the basis of data obtained from subprimates subjected to acute pain stimuli, it has been hypothesized that the suppression of chronic pain in man during stimulation in the periventricular region involves endogenous opioid mechanisms. However, there is at present no direct and unequivocal proof that the pain relief in man is necessarily and entirely dependent upon such mechanisms. There exist several putative substances with opiate-like properties but they are difficult to identify. The assay methods lack specificity and cross-reactions are common. There are only a few studies published on the influence of intracerebral stimulation in man on the CSF-content of opioid substances; the changes observed are inconsistent, and data are only given on patients having satisfactory pain relief. Furthermore, measurements have been made only during the course of a few hours and nothing is reported on the relationship between the changing concentrations of the substance and the level of pain. The observation that Naloxone may reverse the effect of intracerebral stimulation has become the keystone in postulating common mechanisms for stimulation-produced pain relief and morphine analgesia. The fact, that Naloxone is sometime ineffective or has to be used in huge, and unphysiological, doses is generally disregarded. There are a number of substances which may serve as neurotransmittors in pain transmission and pain inhibition but their mode of action in the generation and suppression of chronic pain is entirely unknown. Data collected from various European clinics covering more than 200 patients subjected to intracerebral Stimulation show that the outcome of this treatment is highly unpredictable. Intracerebral Stimulation as a clinically useful treatment of chronic pain can not be further developed unless hard data on its biochemical background in man are provided.

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Authors and Affiliations

  1. Department of Neurosurgery, Karolinska sjukhuset, S-104 01, Stockholm-60, Sweden

    B. A. Meyerson

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  1. B. A. Meyerson
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Editor information

Editors and Affiliations

  1. Western General Hospital and Royal Infirmary, University of Edinburgh, Edinburgh, UK

    F. John Gillingham (Professor of Neurosurgery) (Professor of Neurosurgery)

  2. Academisch Ziekenhuis, Leuven, Belgium

    Jan Gybels (Professor of Neurosurgery) (Professor of Neurosurgery)

  3. Midland Center for Neurosurgery and Neurology and Queen Elizabeth Hospital, University of Birmingham, Birmingham, UK

    Edward Hitchcock (Professor of Neurosurgery) (Professor of Neurosurgery)

  4. Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Roma, Italy

    Gian Franco Rossi (Professor of Neurosurgery) (Professor of Neurosurgery)

  5. Service de Neurochirurgie Fonctionnelle, Centre Hospitalier Sainte Anne, Paris, France

    Gábor Szikla (Maître de Recherche C.N.R.S., Neurosurgeon) (Maître de Recherche C.N.R.S., Neurosurgeon)

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© 1980 Springer-Verlag

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Meyerson, B.A. (1980). Biochemistry of Pain Relief with Intracerebral Stimulation. In: Gillingham, F.J., Gybels, J., Hitchcock, E., Rossi, G.F., Szikla, G. (eds) Advances in Stereotactic and Functional Neurosurgery 4. Acta Neurochirurgica Supplementum, vol 30. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8592-6_28

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  • DOI: https://doi.org/10.1007/978-3-7091-8592-6_28

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-81591-5

  • Online ISBN: 978-3-7091-8592-6

  • eBook Packages: Springer Book Archive

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