title: Caloric Vestibular Stimulation Reduces Pain and Somatoparaphrenia in a Severe Chronic Central Post-Stroke Pain Patient: A Case Study.
abstract: Central post-stroke pain is a neuropathic syndrome characterized by intolerable contralesional pain and, in rare cases, somatic delusions. To date, there is limited evidence for the effective treatments of this disease. Here we used caloric vestibular stimulation to reduce pain and somatoparaphrenia in a 57-year-old woman suffering from central post-stroke pain. Resting-state functional magnetic resonance imaging was used to assess the neurological effects of this treatment. Following vestibular stimulation we observed impressive improvements in motor skills, pain, and somatic delusions. In the functional connectivity study before the vestibular stimulation, we observed differences in the patient's left thalamus functional connectivity, with respect to the thalamus connectivity of a control group (N = 20), in the bilateral cingulate cortex and left insula. After the caloric stimulation, the left thalamus functional connectivity with these regions, which are known to be involved in the cortical response to pain, disappeared as in the control group. The beneficial use of vestibular stimulation in the reduction of pain and somatic delusion in a CPSP patient is now documented by behavioral and imaging data. This evidence can be applied to theoretical models of pain and body delusions.
authors.affiliation: Department of Psychology-Sapienza University of Rome, Rome, Italy.|Laboratory of Neuropsychology, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Grazia Fernanda
authors.initials: GF
authors.lastname: Spitoni
authors.affiliation: Department of Psychology-Sapienza University of Rome, Rome, Italy.|Laboratory of Neuropsychology, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Pireddu
authors.affiliation: Department of Psychology-Sapienza University of Rome, Rome, Italy.|Laboratory of Neuropsychology, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Galati
authors.affiliation: Department of Psychology-Sapienza University of Rome, Rome, Italy.|Laboratory of Neuropsychology, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Sulpizio
authors.affiliation: Laboratory of Neuropsychology, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Paolucci
authors.affiliation: Laboratory of Neuropsychology, IRCCS Santa Lucia Foundation, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Pizzamiglio
mesh_terms: D000698:Analgesia / Q000379:methods; D003702:Delusions; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000503:physiopathology; D059408:Pain Management / Q000379:methods*; D020521:Stroke / Q000473:pathology / Q000503:physiopathology; D013696:Temperature; D013788:Thalamus / Q000473:pathology; D014725:Vestibular Nerve / Q000503:physiopathology