title: Spinal cord stimulation modulates cerebral neurobiology: a proton magnetic resonance spectroscopy study.
abstract: BACKGROUND
  Although spinal cord stimulation (SCS) is a widely used treatment for chronic neuropathic pain secondary to spinal surgery, little is known about the underlying physiological mechanisms.
  
  
  METHODS
  The primary aim of this study is to investigate the neural substrate underlying short-term SCS by means of (1)H MR spectroscopy with short echo time, in 20 patients with failed back surgery syndrome.
  
  
  RESULTS
  Marked increase of γ-aminobutyric acid (GABA) and decrease in glucose in the ipsilateral thalamus were found between baseline situation without SCS and after 9' of SCS, indicating the key role of the ipsilateral thalamus as a mediator of chronic neuropathic pain. In addition, this study also showed a progressive decrease in glucose in the ipsilateral thalamus over time, which is in line with the findings of previous studies reporting deactivation in the ipsilateral thalamic region.
  
  
  CONCLUSIONS
  The observation of GABA increase and glucose decrease over time in the ipsilateral thalamus may be the causal mechanism of the pain relief due to SCS or an epiphenomenon.
authors.affiliation: Department of Neurosurgery and Center for Neuroscience, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium. mtmoens@gmail.com.
authors.forename: Maarten
authors.initials: M
authors.lastname: Moens
authors.affiliation: Department of Neurology, ZNA Middelheim General Hospital, Lindendreef 1, 2020, Antwerp, Belgium.|Department of Clinical and Experimental Neurolinguistics, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Mariën
authors.affiliation: Neurology and Center for Neuroscience, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Raf
authors.initials: R
authors.lastname: Brouns
authors.affiliation: Anesthesiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Poelaert
authors.affiliation: Neurology and Center for Neuroscience, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: De Smedt
authors.affiliation: Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
authors.forename: Ronald
authors.initials: R
authors.lastname: Buyl
authors.affiliation: Cardiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Droogmans
authors.affiliation: Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Van Schuerbeek
authors.affiliation: Department of Radiology, UZ Leuven, Katholieke Universiteit Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sunaert
authors.affiliation: Neurosurgery, UZ Leuven, Katholieke Universiteit Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Nuttin
mesh_terms: D000368:Aged; D059350:Chronic Pain / Q000175:diagnosis / Q000378:metabolism / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology*; D011522:Protons; D062187:Spinal Cord Stimulation / Q000379:methods*; D013788:Thalamus / Q000378:metabolism*; D016896:Treatment Outcome; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000378:metabolism*
chemical_list: D011522:Protons; D005680:gamma-Aminobutyric Acid; D005947:Glucose