Transcranial Magnetic Cortical Stimulation Relieves Central Pain

2002 ◽  
Vol 78 (3-4) ◽  
pp. 192-196 ◽  
Author(s):  
S. Canavero ◽  
V. Bonicalzi ◽  
M. Dotta ◽  
S. Vighetti ◽  
G. Asteggiano ◽  
...  
Keyword(s):  
Cortical Stimulation ◽  
Central Pain ◽  
Transcranial Magnetic Cortical Stimulation

Stereotactic pallidotomy lengthens the transcranial magnetic cortical stimulation silent period in Parkinson's disease

Neurology ◽  
1997 ◽  
Vol 49 (5) ◽  
pp. 1278-1283 ◽  
Author(s):  
M. S. Young ◽  
W. J. Triggs ◽  
D. Bowers ◽  
M. Greer ◽  
W. A. Friedman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Globus Pallidus ◽  
Motor Evoked Potential ◽  
Silent Period ◽  
Cortical Stimulation ◽  
Abductor Pollicis Brevis ◽  
Inhibitory Circuits ◽  
Before And After ◽  
Transcranial Magnetic Cortical Stimulation

We compared the duration of the EMG cortical stimulation silent period(CSSP) elicited in abductor pollicis brevis using transcranial magnetic stimulation (TMS) before and after stereotactic unilateral globus pallidus internus pallidotomy (PAL) in 12 patients with Parkinson's disease. We used TMS stimulus intensities of 200, 150, 120, and 100% of motor evoked potential(MEP) threshold before and after (86 ± 25 days) PAL. PAL increased CSSP duration at stimulus intensities of 200% of MEP threshold in the hand contralateral to the stereotactic lesion. In a subset of five patients able to remain at rest during pre-PAL testing sessions, PAL decreased the resting MEP/M-wave area ratio in the hand contralateral to the lesion at a stimulus intensity of 120% of MEP threshold. PAL did not significantly modify the effects of TMS in the hand ipsilateral to the globus pallidus lesion. The results suggest that PAL improves the function of cortical motor inhibitory circuits in Parkinson's disease.

The muscle silent period following transcranial magnetic cortical stimulation

1993 ◽  
Vol 114 (2) ◽  
pp. 216-222 ◽  
Author(s):  
S.A. Wilson ◽  
R.J. Lockwood ◽  
G.W. Thickbroom ◽  
F.L. Mastaglia
Keyword(s):  
Silent Period ◽  
Cortical Stimulation ◽  
Transcranial Magnetic Cortical Stimulation

scholarly journals Personalizing Dual-Target Cortical Stimulation with Bayesian Parameter Optimization Successfully Treats Central Post-Stroke Pain: A Case Report

2021 ◽  
Vol 12 (1) ◽  
pp. 25
Author(s):  
Evan M. Dastin-van Rijn ◽  
Seth D. König ◽  
Danielle Carlson ◽  
Vasudha Goel ◽  
Andrew Grande ◽  
...  
Keyword(s):  
Case Report ◽  
Memory Task ◽  
Cortical Stimulation ◽  
Bayesian Optimization ◽  
Systematic Evaluation ◽  
Central Pain ◽  
Post Stroke ◽  
Stimulation Parameters ◽  
Dorsolateral Prefrontal ◽  
Personalized Approach

Central pain disorders, such as central post-stroke pain, remain clinically challenging to treat, despite many decades of pharmacological advances and the evolution of neuromodulation. For treatment refractory cases, previous studies have highlighted some benefits of cortical stimulation. Recent advances in new targets for pain and the optimization of neuromodulation encouraged our group to develop a dual cortical target approach paired with Bayesian optimization to provide a personalized treatment. Here, we present a case report of a woman who developed left-sided facial pain after multiple thalamic strokes. All previous pharmacologic and interventional treatments failed to mitigate the pain, leaving her incapacitated due to pain and medication side effects. She subsequently underwent a single burr hole for placement of motor cortex (M1) and dorsolateral prefrontal cortex (dlPFC) paddles for stimulation with externalization. By using Bayesian optimization to find optimal stimulation parameters and stimulation sites, we were able to reduce pain from an 8.5/10 to a 0/10 during a 5-day inpatient stay, with pain staying at or below a 2/10 one-month post-procedure. We found optimal treatment to be simultaneous stimulation of M1 and dlPFC without any evidence of seizure induction. In addition, we found no worsening in cognitive performance during a working memory task with dlPFC stimulation. This personalized approach using Bayesian optimization may provide a new foundation for treating central pain and other functional disorders through systematic evaluation of stimulation parameters.

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