Thalamus and neurogenic pain: physiological, anatomical and clinical data.
Microelectrode recordings in the medial thalamus of 45 neurogenic pain patients undergoing medial thalamotomy revealed that most units (316/318) did not respond to somatosensory stimuli, and that half exhibited low-threshold calcium spike bursts. After medial thalamotomy, 67% of the patients reached a 50 to 100% pain relief, without somatosensory deficits. Colocalization of bursting activities and of the most efficient therapeutic lesions in the central lateral nucleus suggests a key role of this structure in neurogenic pain. We propose that neurogenic pain is due to an imbalance between central lateral and ventroposterior nuclei, resulting in an overinhibition of both by the thalamic reticular nucleus.
Laboratory of Functional Neurosurgery, University Hospital, Zürich, Switzerland.
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D
Jeanmonod
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M
Magnin
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Morel
D005500:Follow-Up Studies; D006801:Humans; D008839:Microelectrodes; D009474:Neurons / Q000502:physiology; D010146:Pain / Q000503:physiopathology* / Q000601:surgery; D010147:Pain Measurement; D013238:Stereotaxic Techniques; D013787:Thalamic Nuclei / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery