Peri-ventricular grey stimulation versus motor cortex stimulation for post stroke neuropathic pain

Nandi, Dipankar; Smith, Helen; Owen, Sarah; Joint, Carole; Stein, John; Aziz, Tipu

doi:10.1054/jocn.2001.1042

Cited by 64 publications

(39 citation statements)

References 23 publications

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“…The other area with many connections is the pre-central gyrus and central sulcus, that has been a target for motor cortex stimulation (MCS) for pain across surgical groups for varying aetiologies with mixed results. [12][13][14][15] It is well documented that the pain neuromatrix has strong links to the affective components of pain. One theory states that pain other than physical sensation governs homeostatic behavioural drive, and thus pain cannot only be considered as a physical condition.…”

Section: Discussionmentioning

confidence: 99%

Pre-operative DTI and probabilisitic tractography in four patients with deep brain stimulation for chronic pain

Owen¹,

Heath²,

Kringelbach³

et al. 2008

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 99%

Pre-operative DTI and probabilisitic tractography in four patients with deep brain stimulation for chronic pain

Owen¹,

Heath²,

Kringelbach³

et al. 2008

Journal of Clinical Neuroscience

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“…Our experience is that DBS is superior to MCS for selected refractory pain syndromes [56]. Similarly, we have found DBS to be more appropriate than SCS for certain pain etiologies, although few published data exist that control for surgeon and patient differences.…”

Section: Introductionmentioning

confidence: 83%

Neuropathic Pain and Deep Brain Stimulation

Pereira

Aziz

2014

Neurotherapeutics

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Deep brain stimulation (DBS) is a neurosurgical intervention the efficacy, safety, and utility of which are established in the treatment of Parkinson's disease. For the treatment of chronic, neuropathic pain refractory to medical therapies, many prospective case series have been reported, but few have published findings from patients treated with current standards of neuroimaging and stimulator technology over the last decade . We summarize the history, science, selection, assessment, surgery, programming, and personal clinical experience of DBS of the ventral posterior thalamus, periventricular/periaqueductal gray matter, and latterly rostral anterior cingulate cortex (Cg24) in 113 patients treated at 2 centers (John Radcliffe, Oxford, UK, and Hospital de São João, Porto, Portugal) over 13 years. Several experienced centers continue DBS for chronic pain, with success in selected patients, in particular those with pain after amputation, brachial plexus injury, stroke, and cephalalgias including anesthesia dolorosa. Other successes include pain after multiple sclerosis and spine injury. Somatotopic coverage during awake surgery is important in our technique, with cingulate DBS under general anesthesia considered for whole or hemibody pain, or after unsuccessful DBS of other targets. Findings discussed from neuroimaging modalities, invasive neurophysiological insights from local field potential recording, and autonomic assessments may translate into improved patient selection and enhanced efficacy, encouraging larger clinical trials.

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“…Nandi et al [59] compared the efficacy of PVG DBS with MCS in CPSP patients. In their study, all 4 patients treated with PVG/ventroposterolateral nucleus DBS chose PVG DBS, and 3 of them underwent chronic stimulation with an implantation of pulse generators; therefore, it seemed that PVG DBS was superior to MCS.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Trial of Deep Brain and Motor Cortex Stimulation in Chronic Intractable Neuropathic Pain

Son

Kim

et al. 2014

Stereotact Funct Neurosurg

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Background/Objectives: Both motor cortex stimulation (MCS) and deep brain stimulation (DBS) of the ventralis caudalis (Vc) thalamus have been shown to be effective in chronic neuropathic pain, and the modulation of thalamic and thalamocortical activity is regarded as a possible mechanism. Although Vc DBS and MCS have a common analgesic mechanism, the application of MCS and DBS is still considered empirical, and there is no consensus on which method is better. Methods: We performed a simultaneous trial of thalamic Vc DBS and MCS in 9 patients with chronic neuropathic pain and investigated the results of the stimulation trial and long-term pain relief. Results: Of the 9 patients initially implanted with both DBS and MCS electrodes, 8 (89%) had a successful trial; 6 of these 8 patients (75%) responded to MCS, and the remaining 2 responded to Vc DBS. During the long-term follow-up, the mean numeric rating scale score decreased significantly (p < 0.05). The percentages of pain relief in the chronic MCS group and the chronic DBS group were 37.9 ± 16.5 and 37.5%, respectively, and there was no statistically significant difference (p = 0.157). Conclusion: Considering the initial success rate and the less invasive nature of epidural MCS compared with DBS, we think that MCS would be a more reasonable initial means of treatment for chronic intractable neuropathic pain.

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Peri-ventricular grey stimulation versus motor cortex stimulation for post stroke neuropathic pain

Cited by 64 publications

References 23 publications

Pre-operative DTI and probabilisitic tractography in four patients with deep brain stimulation for chronic pain

Pre-operative DTI and probabilisitic tractography in four patients with deep brain stimulation for chronic pain

Neuropathic Pain and Deep Brain Stimulation

Simultaneous Trial of Deep Brain and Motor Cortex Stimulation in Chronic Intractable Neuropathic Pain

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