Electrical stimulation of primary motor cortex for intractable neuropathic deafferentation pain Electrical stimulation of primary motor cortex for intractable neuropathic deafferentation pain (pp. 327-338)
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Authors: (Youichi Saitoh)
Abstract: The electrical stimulation of the primary motor cortex (M1)
has proved to be an effective treatment for intractable
neuropathic pain. This treatment started in 1990, and
around thirty studies have been reported. The patients who
have been operated were suffering from central post-stroke
pain (59%), trigeminal neuropathic pain (17%), brachial
plexus injury, spinal cord injury, peripheral nerve injury
and phantom-limb pain. The method of stimulation was a)
epidural, b) subdural and c) within the central sulcus. The
mostly reported cases showed epidural implantation of the
electrode, a few reports subdural. There has been only one
report of the electrode implant within the central sulcus.
Overall, considering the difficulty in treating central
neuropathic pain, trigeminal neuropathic pain and certain
types of refractory peripheral pain, the electrical stimulation
of M1 is a promising technique, but still the success rate
has not been satisfactory. It is very interesting that the
electrode implant within the central sulcus remarkably
reduced intractable pain temporally. The mechanism of
pain relief has been under investigation. Recently, repetitive
transcranial magnetic stimulation (rTMS) of M1 has been
reported to be effective on neuropathic pain. In the future,
rTMS may compete with the electrical stimulation in the
treatment of intractable neuropathic pain.
Electrical stimulation of primary motor cortex for intractable neuropathic deafferentation pain Electrical stimulation of primary motor cortex for intractable neuropathic deafferentation pain (pp. 327-338)