Chronic Motor Cortex Stimulation for Phantom Limb Pain: Correlations between Pain Relief and Functional Imaging Studies

2001 ◽  
Vol 77 (1-4) ◽  
pp. 172-176 ◽  
Author(s):  
J.Ch. Sol ◽  
J. Casaux ◽  
F.E. Roux ◽  
J.A. Lotterie ◽  
P. Bousquet ◽  
...  
Keyword(s):  
Pain Relief ◽  
Motor Cortex ◽  
Functional Imaging ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Imaging Studies ◽  
Limb Pain

Analysis of cortical reorganization (CR) of the patients with phantom-limb pain and the mechanism of motor cortex stimulation

2007 ◽  
Vol 58 ◽  
pp. S29
Author(s):  
Youichi Saitoh ◽  
Takufumi Yanagisawa ◽  
Satoru Oshino ◽  
Masayuki Hirata ◽  
Tetsu Goto ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Phantom Limb Pain ◽  
Cortical Reorganization ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Limb Pain

Long-term motor cortex stimulation for phantom limb pain

2014 ◽  
Vol 29 (2) ◽  
pp. 272-274 ◽  
Author(s):  
Erlick A.C. Pereira ◽  
Tom Moore ◽  
Liz Moir ◽  
Tipu Z. Aziz
Keyword(s):  
Motor Cortex ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Limb Pain

Chronic Motor Cortex Stimulation for Phantom Limb Pain Control: Correlations between Analgesic Effects and Cortex Mapping

Neurosurgery ◽  
2005 ◽  
Vol 57 (2) ◽  
pp. 413-413
Author(s):  
Yves Lazorthes ◽  
Jean-Christophe Sol ◽  
Pascal Cintas ◽  
Jean-Albert Lotterie ◽  
Jean-Claude Verdie ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Pain Control ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Limb Pain ◽  
Analgesic Effects

Motor cortex stimulation for phantom limb pain

The Lancet ◽  
1999 ◽  
Vol 353 (9148) ◽  
pp. 212 ◽  
Author(s):  
Youichi Saitoh ◽  
Masahiko Shibata ◽  
Yasuhiro Sanada ◽  
Takashi Mashimo
Keyword(s):  
Motor Cortex ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Limb Pain

Motor Cortex Stimulation for Phantom Limb Pain: Comprehensive Therapy with Spinal Cord and Thalamic Stimulation

2001 ◽  
Vol 77 (1-4) ◽  
pp. 159-162 ◽  
Author(s):  
Yoichi Katayama ◽  
Takamitsu Yamamoto ◽  
Kazutaka Kobayashi ◽  
Masahiko Kasai ◽  
Hideki Oshima ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Motor Cortex ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Limb Pain ◽  
Thalamic Stimulation ◽  
Comprehensive Therapy

Chronic Motor Cortex Stimulation for Phantom Limb Pain: A Functional Magnetic Resonance Imaging Study: Technical Case Report

Neurosurgery ◽  
2001 ◽  
Vol 48 (3) ◽  
pp. 681-688 ◽  
Author(s):  
Franck-Emmanuel Roux ◽  
Danielle Ibarrola ◽  
Yves Lazorthes ◽  
Isabelle Berry
Keyword(s):  
Motor Cortex ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Electrode Placement ◽  
Control Mechanisms ◽  
Motor Cortex Stimulation ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Limb Pain ◽  
Stereotactic Device

Abstract OBJECTIVE AND IMPORTANCE Chronic motor cortex stimulation has provided satisfactory control of pain in patients with central or neuropathic trigeminal pain. We used this technique in a patient who experienced phantom limb pain. Functional magnetic resonance imaging (fMRI) was used to guide electrode placement and to assist in understanding the control mechanisms involved in phantom limb pain. CLINICAL PRESENTATION A 45-year-old man whose right arm had been amputated 2 years previously experienced phantom limb pain and phantom limb phenomena, described as the apparent possibility of moving the amputated hand voluntarily. He was treated with chronic motor cortex stimulation. INTERVENTION Data from fMRI were used pre- and postoperatively to detect shoulder and stump cortical activated areas and the “virtual” amputated hand cortical area. These sites of preoperative fMRI activation were integrated in an infrared-based frameless stereotactic device for surgical planning. Phantom limb virtual finger movement caused contralateral primary motor cortex activation. Satisfactory pain control was obtained; a 70% reduction in the phantom limb pain was achieved on a visual analog scale. Postoperatively and under chronic stimulation, inhibiting effects on the primary sensorimotor cortex as well as on the contralateral primary motor and sensitive cortices were detected by fMRI studies. CONCLUSION Chronic motor cortex stimulation can be used to relieve phantom limb pain and phantom limb phenomena. Integrated by an infrared-based frameless stereotactic device, fMRI data are useful in assisting the neurosurgeon in electrode placement for this indication. Pain control mechanisms and cortical reorganization phenomena can be studied by the use of fMRI.

scholarly journals Mechanistic analysis of motor cortex stimulation for phantom limb pain

PAIN RESEARCH ◽  
2008 ◽  
Vol 23 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Takufumi Yanagisawa ◽  
Youichi Saitoh ◽  
Masayuki Hirata ◽  
Okito Yamashita ◽  
Yukiyasu Kamitani ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Limb Pain ◽  
Mechanistic Analysis

Motor cortex stimulation for central pain and peripheral deafferentation pain

2000 ◽  
Vol 92 (1) ◽  
pp. 150-155 ◽  
Author(s):  
Youichi Saitoh ◽  
Masahiko Shibata ◽  
Shun-ichiro Hirano ◽  
Masayuki Hirata ◽  
Takashi Mashimo ◽  
...  
Keyword(s):  
Pain Relief ◽  
Motor Cortex ◽  
Electrode Array ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Content Type ◽  
Deafferentation Pain ◽  
Pharmacological Test ◽  
Fine Print

✓ The authors tested a modified motor cortex stimulation protocol for treatment of central and peripheral types of deafferentation pain. Four patients with thalamic pain and four with peripheral deafferentation pain were studied. Preoperative pharmacological tests of pain relief were performed using phentolamine, lidocaine, ketamine, thiopental, and placebo. In five patients we placed a 20- or 40-electrode grid in the subdural space to determine the best stimulation point for pain relief for a few weeks before definitive placement of a four-electrode array. In three patients, the four-electrode array was implanted in the interhemispheric fissure as a one-stage procedure to treat lower-extremity pain. In two patients with pain extending from the extremity to the trunk or hip, dual devices were implanted to drive two electrodes.Six of eight patients experienced pain reduction (two each with excellent, good, and fair relief) from motor cortex stimulation. No correlation was apparent between pharmacological test results and the effectiveness of motor cortex stimulation. Patients with peripheral deafferentation pain, including two with phantom-limb pain and two with brachial plexus injury, attained pain relief from motor cortex stimulation, with excellent results in two cases. Testing performed with a subdural multiple-electrode grid was helpful in locating the best stimulation point for pain relief. Motor cortex stimulation may be effective for treating peripheral as well as central deafferentation pain.

Motor cortex stimulation for deafferentation pain

2001 ◽  
Vol 11 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Youichi Saitoh ◽  
Shun-ichiro Hirano ◽  
Amami Kato ◽  
Haruhiko Kishima ◽  
Masayuki Hirata ◽  
...  
Keyword(s):  
Pain Relief ◽  
Motor Cortex ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Grid Electrode ◽  
Deafferentation Pain ◽  
Test Stimulation ◽  
Brain Surface ◽  
Cord Injury

Object The authors tested a modified motor cortex stimulation (MCS) protocol for the treatment of deafferentation pain in 15 patients: eight patients with poststroke pain, four with brachial plexus injury, two with phantom limb pain, and one with spinal cord injury. Methods Preoperative pharmacological tests were performed with phentolamine, lidocaine, ketamine, thiopental, morphine, and a placebo. In 12 patients we placed a 20– or 40–grid electrode in the subdural space to determine the best stimulation point for pain relief over a few weeks and therefore the optimum position for a permanent internal device. In four patients, the MCS devices were implanted in the interhemispheric fissure to reduce lower-extremity pain. In one patient, the MCS device was placed within the central sulcus, and a 20-grid electrode was placed on the brain surface. In two patients with pain extending from the upper extremity to the hyperbody, dual-electrode devices were implanted to drive two electrodes. In 10 of the 15 patients MCS-induced pain reduction was achieved (four with excellent, two with good, and four with fair alleviation of pain). The result of pharmacological testing indicated that patients with ketamine sensitivity seem to be good candidates for MCS. Conclusions Test stimulation with a subdural multigrid electrode was helpful in locating the best stimulation point for pain relief.

Effects of Combined and Alone Transcranial Motor Cortex Stimulation and Mirror Therapy in Phantom Limb Pain: A Randomized Factorial Trial

2021 ◽  
pp. 154596832110175
Author(s):  
Muhammed Enes Gunduz ◽  
Kevin Pacheco-Barrios ◽  
Camila Bonin Pinto ◽  
Dante Duarte ◽  
Faddi Ghassan Saleh Vélez ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Lower Limb ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Motor Cortex Stimulation ◽  
Mirror Therapy ◽  
Limb Pain ◽  
Factorial Trial ◽  
Motor Cortex Plasticity

Phantom limb pain (PLP) is a frequent complication in amputees, which is often refractory to treatments. We aim to assess in a factorial trial the effects of transcranial direct current stimulation (tDCS) and mirror therapy (MT) in patients with traumatic lower limb amputation; and whether the motor cortex plasticity changes drive these results. In this large randomized, blinded, 2-site, sham-controlled, 2 × 2 factorial trial, 112 participants with traumatic lower limb amputation were randomized into treatment groups. The interventions were active or covered MT for 4 weeks (20 sessions, 15 minutes each) combined with 2 weeks of either active or sham tDCS (10 sessions, 20 minutes each) applied to the contralateral primary motor cortex. The primary outcome was PLP changes on the visual analogue scale at the end of interventions (4 weeks). Motor cortex excitability and cortical mapping were assessed by transcranial magnetic stimulation (TMS). We found no interaction between tDCS and MT groups ( F = 1.90, P = .13). In the adjusted models, there was a main effect of active tDCS compared to sham tDCS (beta coefficient = −0.99, P = .04) on phantom pain. The overall effect size was 1.19 (95% confidence interval: 0.90, 1.47). No changes in depression and anxiety were found. TDCS intervention was associated with increased intracortical inhibition (coefficient = 0.96, P = .02) and facilitation (coefficient = 2.03, P = .03) as well as a posterolateral shift of the center of gravity in the affected hemisphere. MT induced no motor cortex plasticity changes assessed by TMS. These findings indicate that transcranial motor cortex stimulation might be an affordable and beneficial PLP treatment modality.

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