Summary
In the last 5 years several remarkable methods for localizing precisely a wide range not only of specific motor and sensory functions but as well of more complex mental phenomena in the domain of cognitive functions have been demonstrated to evoke sharply localizable responses. In pain, positron emission tomography (PET) scanning has been used to show that the anterior gyrus cinguli is an integral component of the pain system.
The PET technique suffers from a limitation of both spatial and temporal resolution, which permits only accurate center of mass coordinates of activated regions. Functional mapping of the brain by nuclear magnetic resonance has been achieved with techniques depicting specific brain areas in action during a mental process. These techniques open up an entirely new domain for study and treatment of many problems linked to cognition including many in whom pain is a central feature.
The many cerebral cortical areas involved in pain make it unlikely that any ablative procedure will achieve long sustained pain relief. The dual objective of relief of both pain and suffering is probably going to be attained only by activation of pain suppressor mechanisms. This may well require the added knowledge accessible only by functional magnetic resonance imaging.
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References
Ball J, Klett CJ, Gresock CJ (1959) The veterans administration study of prefrontal lobotomy. J Clin Exp Psychopathol Q Rev Psychiatr Neurol 20: 205–217
Ballantine HT Jr, Girinus IE (1988) Treatment of intractable psychiatric illness and chronic pain by stereotactic cingulotomy. In: Schmidek HH et al (eds) Operative neurosurgical techniques. Indications, methods, and results. Grune and Stratton, Orlando, pp 1069–1075
Bandettini PA, Wong EC, Hinks RD et al (1992) Time course EPI of human brain function during task activation. MRM 25: 390–397
Belliveau JW, Kennedy DN, McKinstry RC et al (1991) Functional mapping of the human visual cortex by magnetic resonance imaging. Science 254: 716–719
Blamire AM, Ogawa S, Igurbil K et al (1992) Dynamic mapping of the human visual cortex by high-speed magnetic resonance imaging. Proc Natl Acad Sci 89: 11069–11073
Coghill RC, Talbot JD, Evans AC et al (1994) Distributed processing of pain and vibration by the human brain. J Neurosci 14: 4095–4108
Freeman W, Watts JW (1950) Psychosurgery in the treatment of mental disorders and intractable pain. Transorbital lobotomy. Thomas, Springfield, pp 51–61
Gybels J, Sweet WH (1989) The neurosurgical treatment of persistent pain. Karger, Basel, pp 254–256
Hasse A, Frahm H, Hanicke W et al (1986) FLASH imaging. Rapid NMR imaging using low flip angle pulses. J Magn Reson 67: 257–266
Jack CR, Thompson RM, Butts RK et al (1994) Sensory motor cortex: correlation of presurgical mapping with function MR imaging and invasive cortical mapping. Radiology 190: 85–92
Kim S-G, Ashe J, Hendrich K et al (1993) Functional magnetic resonance imaging of motor cortex hemispheric asymmetry and handedness. Science 261: 615–616
Kim S-G, Ugurbil K, Strick PL (1994) Activation of a cerebellar output nucleus during cognitive processing. Science 265: 949–951
Kwong KK, Belliveau JW, Chesler DA (1992) Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation. Proc Natl Acad Sci 89: 5675–5679
Menon RS, Ogawa S, Kim S-G (1992) Functional brain mapping using magnetic resonance imaging. Invest Radiol 27: S47–S53
Morris GL, Mueller WM, Yetkin FZ et al (1994) Functional magnetic resonance imaging in partial epilepsy. Epilepsia 35: 1194–1198
Ogawa S, Tank DW, Menon R et al (1992) Intrinsic signal changes accompanying sensory stimulation: functional brain mapping with magnetic resonance imaging. Proc Natl Acad Sci 89: 5951–5955
Pauling L, Coryell CD (1936) The magnetic properties and structure of hemoglobin, Oxyhemoglobin and carbonoxyhemo- globin. Proc Natl Acad Sci 22: 210–216
Rao SM, Bandettini P, Wong PC et al (1992) Gradient-echo EPI demonstrates bilateral superior temporal gyrus activation during passive word presentation. Book of Abstracts, 11th Annual Meeting. Society for Magnetic Resonance in Medicine, Berlin, p 1827
Rao SM, Binder JR, Bandettini PA et al (1993) Functional magnetic resonance imaging of complex human movements. Neurology 43: 2311–2318
Roland PE, Larson B, Lassen NA et al (1980) Supplementary motor area and other cortical areas in organization of voluntary movements in man. J Neurophysiol 43: 118–136
Rosen BR, Belliveau JW, Vevea JM et al (1990) Perfusion imaging with NMR contrast agents. MRM 14: 249–265
Sweet WH (1973) Treatment of medically intractable mental disease by limited frontal leucotomy - justifiable? N Engl J Med 289: 1117–1118
Sweet WH, Poletti CE, Umansky F (1982) Neurosurgical techniques to control the pain of superior pulmonary sulcus and other tumors in this region. In: Bonica JJ et al (eds) Advances in pain research and therapy, Vol 4. Raven, New York, pp 211–233
Teuber H-L, Corkin SH Twitchell TE (1977) Study of cin- gulotomy in man: a summary. In: Sweet WH et al (eds) Neurosurgical treatment in psychiatry, pain, and epilepsy. University Park Press, Baltimore, pp 355–365
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Sweet, W.H. (1995). Pain—Old and New Methods of Study and Treatment. In: Meyerson, B.A., Ostertag, C. (eds) Advances in Stereotactic and Functional Neurosurgery 11. Acta Neurochirurgica Supplementum, vol 64. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9419-5_18
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DOI: https://doi.org/10.1007/978-3-7091-9419-5_18
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