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Motor cortex stimulation in the treatment of neuropathic pain
Affiliations- Gumed Klinika Neurochirurgii, Smoluchowskiego
- II Klinika Neurologii, Instytut Psychiatrii i Neurologii w Warszawie
- Zakład Fizjologii Człowieka, Warszawski Uniwersytet Medyczny
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Abstract
Despite the rapid development of neuropharmacotherapy, medical treatment of neuropathic pain (NP) still constitutes a significant socioeconomic problem. The authors herein present a group of patients treated with motor cortex stimulation (MCS) for NP of various types and aetiologies.
Material and methodsOur cohort included 12 female and 11 male NP patients aged 53 ± 16 treated with MCS. Eleven patients were diagnosed with neuropathic facial pain (NFP), 8 with hemi-body neuropathic pain (HNP), and 4 with deafferentation pain (DP). Prior to surgery, 16 out of 23 patients were treated with repetitive transcranial magnetic stimulation (rTMS), with a positive response in 10 cases. Pain intensity in our group was evaluated with the visual analogue scale (VAS) one month before and three months after MCS implantation.
ResultsImprovement on the VAS was reported in the whole group of patients (p < 0.001). The best results were reported in the NFP group (p < 0.001) while the worst ones were noted in the DP group (p = 0.04). Anamnesis duration positively correlated with outcome. Infection forced the authors to permanently remove the system in one case. There were no other complications in the group.
ConclusionsMinimally invasive, safe neuromodulative treatment with MCS permits neuropathic pain control with good efficacy. The type of neuropathic pain might be a prognostic factor.
Abstract
Despite the rapid development of neuropharmacotherapy, medical treatment of neuropathic pain (NP) still constitutes a significant socioeconomic problem. The authors herein present a group of patients treated with motor cortex stimulation (MCS) for NP of various types and aetiologies.
Material and methodsOur cohort included 12 female and 11 male NP patients aged 53 ± 16 treated with MCS. Eleven patients were diagnosed with neuropathic facial pain (NFP), 8 with hemi-body neuropathic pain (HNP), and 4 with deafferentation pain (DP). Prior to surgery, 16 out of 23 patients were treated with repetitive transcranial magnetic stimulation (rTMS), with a positive response in 10 cases. Pain intensity in our group was evaluated with the visual analogue scale (VAS) one month before and three months after MCS implantation.
ResultsImprovement on the VAS was reported in the whole group of patients (p < 0.001). The best results were reported in the NFP group (p < 0.001) while the worst ones were noted in the DP group (p = 0.04). Anamnesis duration positively correlated with outcome. Infection forced the authors to permanently remove the system in one case. There were no other complications in the group.
ConclusionsMinimally invasive, safe neuromodulative treatment with MCS permits neuropathic pain control with good efficacy. The type of neuropathic pain might be a prognostic factor.
Keywords
neuropathic pain, cortical stimulation, transcranial magnetic stimulation
About this articleTitle
Motor cortex stimulation in the treatment of neuropathic pain
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
428-435
Page views
379
Article views/downloads
568
DOI
10.5114/ninp.2012.31352
Bibliographic record
Neurol Neurochir Pol 2012;46(5):428-435.
Keywords
neuropathic pain
cortical stimulation
transcranial magnetic stimulation
Authors
Tomasz Mandat
Henryk Koziara
Sławomir Barszcz
Rafał Rola
Michał Karliński
Anna Śliwińska
Stephane Palfi
Radosław Michalik
Artur Oziębło
Jacek Kunicki
Paweł Nauman
Wiesław Bonicki
