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Somatosensory cortex stimulation for deafferentation pain

  • Chapter
Operative Neuromodulation

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 97/2))

Abstract

Functional neuroimaging has demonstrated that a relationship exists between the intensity of deafferentation pain and the degree of deafferentation- related reorganization of the primary somatosensory cortex. It has also revealed that this cortical reorganization can be reversed after the attenuation of pain. Deafferentation pain is also associated with hyperactivity of the somatosensory thalamus and cortex. Therefore, in order to suppress pain, it seems logical to attempt to modify this deafferentation- related somatosensory cortex hyperactivity and reorganization. This can be achieved using neuronavigation-guided transcranial magnetic stimulation (TMS), a technique that is capable of modulating cortical activity. If TMS is capable of suppressing deafferentation pain, this benefit should be also obtained by the implantation of epidural stimulating electrodes over the area of electrophysiological signal abnormality in the primary somatosensory cortex. The first studies demonstrated a statistically significant pain suppression in all patients and a clinically significant pain suppression in 80% of them. This clinical experience suggests that somatosensory cortex stimulation may become a neurophysiology- based new approach for treating deafferentation pain in selected patients. In this chapter, we review the relevant recent reports and describe our studies in this field.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital Antwerp, Belgium

    Dirk De Ridder & G. De Mulder

  2. Department of Psychology, Free University Brussels, Belgium

    E. Verstraeten

  3. Department of Radiology, University Hospital Louvain, Belgium

    S. Sunaert

  4. School of Behavioral and Brain Sciences, University of Texas at Dallas, USA

    A. Moller

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  1. Dirk De Ridder
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  2. G. De Mulder
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  3. E. Verstraeten
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  4. S. Sunaert
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  5. A. Moller
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Correspondence to Dirk De Ridder .

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Editors and Affiliations

  1. Department of Neurosurgery, University of Athens, Athens, Greece

    Damianos E. Sakas

  2. University Hospital of Wales, Cardiff, UK

    Brian A. Simpson

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De Ridder, D., De Mulder, G., Verstraeten, E., Sunaert, S., Moller, A. (2007). Somatosensory cortex stimulation for deafferentation 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_8

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