Stimulation of primary motor cortex for intractable deafferentation pain

被引:28
作者
Saitoh, Y. [1 ,2 ]
Hirayama, A. [1 ,2 ]
Kishima, H. [1 ,2 ]
Oshino, S. [1 ,2 ]
Hirata, M. [1 ,2 ]
Kato, A. [1 ,2 ]
Yoshimine, T. [1 ,2 ]
机构
[1] Osaka Univ, Grad Sch Med, Dept Neurosurg, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan
[2] Osaka Univ, Grad Sch Med, Ctr Pain Management, Suita, Osaka 5650871, Japan
来源
ADVANCES IN FUNCTIONAL AND REPARATIVE NEUROSURGERY | 2006年 / 99卷
关键词
repetitive transcranial magnetic stimulation (rTMS); deafferentation pain; navigation; motor cortex; image-guided;
D O I
10.1007/978-3-211-35205-2_11
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
To treat intractable deafferentation pains, we prefer stimulation of the primary motor cortex (M1). The methods of stimulation we utilize are electrical stimulation and repetitive transcranial magnetic stimulation (rTMS). In our department, we first attempt rTMS, and if this rTMS is effective, we recommend the patient to undergo procedures for motor cortex stimulation (MCS). A 90% intensity of resting motor threshold setting is used for rTMS treatment. In this study ten trains of 5 Hz rTMS for 10 seconds (50 seconds resting interval) were applied to the M1, S1, pre-motor and supplementary motor areas. Only M1 stimulation was effective for pain reduction in 10 of 20 patients (50%). Twenty-nine MCS procedures were performed by subdural implantation of electrodes, and in the case of hand or face pain, electrodes were implanted within the central sulcus (I I cases), because the main part of M I is located in the central sulcus in humans. The success rate of MCS was around 63%, and seemed to be higher in cases of pain with spinal cord and peripheral origins, while it was lower in cases of post-stroke pain.
引用
收藏
页码:57 / +
页数:2
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