Efficacy of Motor Cortex Stimulation for Intractable Central Neuropathic Pain: Comparison of Stimulation Parameters Between Post-stroke Pain and Other Central Pain

• TANEI Takafumi

  Department of Neurosurgery, Nagoya Central Hospital Department of Neurosurgery, Nagoya University Graduate School of Medicine

• KAJITA Yasukazu

  Department of Neurosurgery, Nagoya University Graduate School of Medicine

• NODA Hiroshi

  Department of Neurosurgery, Kasugai Municipal Hospital

• TAKEBAYASHI Shigenori

  Department of Neurosurgery, Nagoya Central Hospital

• NAKATSUBO Daisuke

  Department of Neurosurgery, National Hospital for Geriatric Medicine

• MAESAWA Satoshi

  Department of Neurosurgery, Nagoya University Graduate School of Medicine

• WAKABAYASHI Toshihiko

  Department of Neurosurgery, Nagoya University Graduate School of Medicine

抄録

Motor cortex stimulation (MCS) has now become the preferred option for neurosurgical management of intractable central neuropathic pain such as post-stroke pain and trigeminal neuropathic pain. However, the efficacy of MCS for other central neuropathic pain such as pain resulting from spinal cord or brainstem lesions is unclear. We retrospectively reviewed 11 consecutive patients with intractable central neuropathic pain who underwent MCS in our institution. Eight patients had poststroke pain caused by thalamic hemorrhage (n = 5) or infarction (n = 3) (thalamic group). Two patients had postoperative neuropathic pain caused by spinal cord lesions, and one patient had facial pain caused by a brainstem lesion associated with multiple sclerosis (brainstem-spinal group). Visual analog scale and stimulation parameters were evaluated at 1 and 6 months postoperatively. MCS was effective for six of eight patients in the thalamic group, and all three patients in the brainstem-spinal group. These efficacies continued for 6 months after surgery without significant change in the stimulation parameters compared with the parameters at 1 month in both groups. The mean amplitude at 1 month and frequency at 6 months after surgery were significantly higher in the brainstem-spinal group than the thalamic group, although the patient number was small. MCS is effective for other central neuropathic pain, but higher intensity stimulation parameters may be necessary to gain adequate pain reduction.<br>

収録刊行物

• Neurologia medico-chirurgica

  Neurologia medico-chirurgica 51 (1), 8-14, 2011

  一般社団法人 日本脳神経外科学会

キーワード

• motor cortex stimulation
• central neuropathic pain
• spinal cord
• deep brain stimulation
• stimulation parameter

詳細情報

• CRID: 1390001205055301760
• NII論文ID: 10028104454
• NII書誌ID: AN00358613
• DOI: 10.2176/nmc.51.8
• ISSN: 13498029
• ISSN: 04708105
• Web Site: http://www.jstage.jst.go.jp/article/nmc/51/1/51_1_8/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2011165142
• 本文言語コード: en
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