Activation of the anterior cingulate cortex by thalamic stimulation in patients with chronic pain: a positron emission tomography study

被引:76
作者
Davis, KD
Taub, E
Duffner, F
Lozano, AM
Tasker, RR
Houle, S
Dostrovsky, JO
机构
[1] Univ Toronto, Dept Surg, Toronto, ON, Canada
[2] Univ Toronto, Dept Physiol, Toronto, ON, Canada
[3] Clarke Inst Psychiat, PET Ctr, Toronto, ON M5T 1R8, Canada
[4] Toronto Western Res Inst, Toronto, ON, Canada
关键词
thalamus; pain; positron emission tomography scanning; cingulate cortex;
D O I
10.3171/jns.2000.92.1.0064
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. Deep brain stimulation (DBS) of the sensory thalamus has been used to treat chronic, intractable pain. The goal of this study was to investigate the thalamocortical pathways activated during thalamic DBS. Methods. The authors compared positron emission tomography (PET) images obtained before, during, and after DBS in five patients with chronic pain. Two of the five patients reported significant DBS-induced pain relief during PET scanning, and the remaining three patients did not report any analgesic effect of DBS during scanning. The most robust effect associated with DBS was activation of the anterior cingulate cortex (ACC). An anterior ACC activation was sustained throughout the 40 minutes of DBS, whereas a more posteriorly located ACC activation occurred at a delay after onset of DBS, although these activations were not dependent on the degree of pain relief reported during DBS. However, implications specific to the analgesic effect of DBS require Further study of a larger, more homogeneous patient population. Additional effects of thalamic DBS were detected in motor-related regions (the globus pallidus, cortical area 4, and the cerebellum) and visual and association cortical areas. Conclusions. The authors demonstrate that the ACC is activated during thalamic DBS in patients with chronic pain.
引用
收藏
页码:64 / 69
页数:6
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