title: Motor cortex stimulation for post-stroke pain: comparison of spinal cord and thalamic stimulation.
abstract: We analyzed the effects of spinal cord stimulation (SCS), deep brain stimulation (DBS) of the thalamic nucleus ventralis caudalis (VC) and motor cortex stimulation (MCS) in 45 patients with post-stroke pain. Satisfactory pain control was obtained more frequently as the stimulation site was moved to higher levels (7% by SCS, 25% by DBS and 48% by MCS). A painful sensation was sometimes produced by stimulation of the VC as well as the post-central, pre-central and pre-frontal cortices. Such a sensation occurred less frequently as the stimulation site was moved to higher levels (50% at the VC, 39% at the post-central cortex, 6% at the pre-central cortex and 3% at the pre-frontal cortex). These findings imply that abnormal processing of nociceptive information develops at the level of deafferentation and spreads to higher levels to a varying extent. This may be one of the reasons why satisfactory pain control was obtained more frequently as the stimulation site was moved to higher levels.
authors.affiliation: Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan. ykatayam@med.nihon-u.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Katayama
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.forename: K
authors.initials: K
authors.lastname: Kobayashi
authors.forename: M
authors.initials: M
authors.lastname: Kasai
authors.forename: H
authors.initials: H
authors.lastname: Oshima
authors.forename: C
authors.initials: C
authors.lastname: Fukaya
mesh_terms: D000698:Analgesia / Q000379:methods*; D002422:Causalgia / Q000628:therapy*; D004558:Electric Stimulation / Q000009:adverse effects; D004599:Electric Stimulation Therapy / Q000295:instrumentation; D004567:Electrodes, Implanted; D009044:Motor Cortex / Q000503:physiopathology*; D010292:Paresthesia / Q000209:etiology; D012189:Retrospective Studies; D013116:Spinal Cord / Q000503:physiopathology*; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D016896:Treatment Outcome; D020651:Ventral Thalamic Nuclei / Q000503:physiopathology*