Antinociception induced by motor cortex stimulation: Somatotopy of behavioral response and profile of neuronal activation

França, N.R.; Toniolo, Elaine F.; Franciosi, Adriano C.; Alves, A.S.; Andrade, Daniel Ciampi de; Fonoff, Erich Talamoni; Britto, Luiz Roberto Giorgetti de; Dale, Camila S.

doi:10.1016/j.bbr.2013.05.019

Cited by 35 publications

(26 citation statements)

References 38 publications

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“…Activation of the striatal dopaminergic system, on the other hand, seems to be involved as well 100,101 . The release of noradrenalin (locus coeruleus) 102 and serotonin (the rostroventromedial medulla) 103,104 has been described to be involved in the analgesic effects of iMCS as well. The role of N-meyhyl-D-aspartate receptors in explaining the effects of iMCS has also been reported as important 105,106 .…”

Section: Discussionmentioning

confidence: 99%

“…The role of N-meyhyl-D-aspartate receptors in explaining the effects of iMCS has also been reported as important 105,106 . Finally, mechanisms of the descending volleys in the spinal cord have also been described 103,104,107 . The activation of stellate interneurons in the fourth layer of the cerebral cortex is assumed to explain such wide-spread effects of iMCS [108][109][110][111][112][113][114] .…”

Section: Discussionmentioning

confidence: 99%

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Motor cortex stimulation in chronic neuropathic orofacial pain syndromes: a systematic review and meta-analysis

Henssen

Kurt

Walsum

et al. 2020

Sci Rep

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Invasive motor Cortex Stimulation (iMCS) was introduced in the 1990's for the treatment of chronic neuropathic orofacial pain (CNOP), although its effectiveness remains doubtful. However, CNOP is known to be a heterogeneous group of orofacial pain disorders, which can lead to different responses to iMCS. Therefore, this paper investigated (1) whether the effectiveness of iMCS is significantly different among different CNOP disorders and (2) whether other confounding factors can be impacting iMCS results in CNOP. A systematic review and meta-analysis using a linear mixed-model was performed. Twenty-three papers were included, totaling 140 CNOP patients. Heterogeneity of the studies showed to be 55.8%. A visual analogue scale (VAS) measured median pain relief of 66.5% (ranging from 0-100%) was found. Linear mixed-model analysis showed that patients suffering from trigeminal neuralgia responded significantly more favorable to iMCS than patients suffering from dysfunctional pain syndromes (p = 0.030). Also, patients suffering from CNOP caused by (supra)nuclear lesions responded marginally significantly better to iMCS than patients suffering from CNOP due to trigeminal nerve lesions (p = 0.049). No other confounding factors were elucidated. This meta-analysis showed that patients suffering from trigeminal neuralgia and patients suffering from (supra)nuclear lesions causing CNOP responded significantly more favorable than others on iMCS. No other confounding factors were found relevant.In the early 1990's, Tsubokawa and his colleagues searched for a new therapy to treat intractable neuropathic pain as other forms of therapies, including continuous deep brain stimulation of thalamic nuclei, only provided satisfactory pain relief in approximately 30% of the cases. For that reason, they started to empirically stimulate various brain regions in animal models for intractable neuropathic pain. During their experiments, they recognized the primary motor cortex as a target that could provide excellent pain relief. Within their experiments, Tsubokawa transected the spinothalamic tract in cats, which led to thalamic hyperactivity and pain-related behavior. By stimulating the primary motor cortex in these cats, it was found that both the hyperactivity was inhibited and the pain-related behavior diminished, indicating an analgesic effect of iMCS in the treated cats. These experimental findings were in line with their subsequent clinical investigations in individuals suffering from intractable neuropathic pain as a consequence of thalamic syndrome 1-5 . Since then, iMCS has been carried out in approximately 700 cases world-wide, yielding highly variable outcomes 1,6-40 . Nevertheless, iMCS has become a last resort neurosurgical therapy for different intractable neuropathic pain syndromes 3-5,14,17,21,26,35,41-44 . In 1993, Meyerson et al. reported for the first time on the use of iMCS in chronic neuropathic orofacial pain (CNOP) as a last resort treatment. They reported that, in a case series of 10 individuals suffering from CNOP...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Motor cortex stimulation in chronic neuropathic orofacial pain syndromes: a systematic review and meta-analysis

Henssen

Kurt

Walsum

et al. 2020

Sci Rep

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“…Direct M1 stimulation elicits contralateral somatotopic analgesia by inhibiting thalamic sensory neurons and disinhibiting the neurons in the PAG, an area rich in μ-opioid receptors [33]. In fact, a recent PET study from our group using C 11 carfentanil, a selective μ-opioid radiotracer, showed that conventional M1-SO tDCS induces immediate μ-opioid activation in the PAG in humans [11].…”

Section: Discussionmentioning

confidence: 99%

High-Definition and Non-invasive Brain Modulation of Pain and Motor Dysfunction in Chronic TMD

et al. 2015

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Background Temporomandibular disorders (TMD) have a relatively high prevalence and in many patients pain and masticatory dysfunction persist despite a range of treatments. Non-invasive brain neuromodulatory methods, namely transcranial direct current stimulation (tDCS), can provide relatively long-lasting pain relief in chronic pain patients. Objective To define the neuromodulatory effect of five daily 2×2 motor cortex high-definition tDCS (HD-tDCS) sessions on clinical pain and motor measures in chronic TMD patients. It is predicted that M1 HD-tDCS will selectively modulate clinical measures, by showing greater analgesic after-effects compared to placebo, and active treatment will increase pain free jaw movement more than placebo. Methods Twenty-four females with chronic myofascial TMD pain underwent five daily, 20-minute sessions of active or sham 2 milliamps (mA) HD-tDCS. Measurable outcomes included pain-free mouth opening, visual analog scale (VAS), sectional sensory-discriminative pain measures tracked by a mobile application, short form of the McGill Pain Questionnaire, and the Positive and Negative Affect Schedule. Follow-up occurred at one-week and four-weeks post treatment. Results There were significant improvements for clinical pain and motor measurements in the active HD-tDCS group compared to the placebo group for: responders with pain relief above 50% in the VAS at four-week follow-up (p=0.04); pain-free mouth opening at one-week follow-up (p<0.01); and sectional pain area, intensity and their sum measures contralateral to putative M1 stimulation during the treatment week (p<0.01). No changes in emotional values were shown between groups. Conclusion Putative M1 stimulation by HD-tDCS selectively improved meaningful clinical sensory-discriminative pain and motor measures during stimulation, and up to four weeks post-treatment in chronic myofascial TMD pain patients.

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“…In contrast, the activation of the cortices surrounding the IC, specifically the rat motor cortex [28,29,30,31,32], S1 [33,34], S2 [34,35] and anterior cingulate cortex [36], facilitates descending inhibition, and thus weakens nociception.…”

Section: Suppressive Effects Of Damgo On Cortical Excitatory Propagationmentioning

confidence: 82%

Opposite effects of mu and delta opioid receptor agonists on excitatory propagation induced in rat somatosensory and insular cortices by dental pulp stimulation

Yokota

Koyanagi

Nakamura

et al. 2016

Neuroscience Letters

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Antinociception induced by motor cortex stimulation: Somatotopy of behavioral response and profile of neuronal activation

Cited by 35 publications

References 38 publications

Motor cortex stimulation in chronic neuropathic orofacial pain syndromes: a systematic review and meta-analysis

Motor cortex stimulation in chronic neuropathic orofacial pain syndromes: a systematic review and meta-analysis

High-Definition and Non-invasive Brain Modulation of Pain and Motor Dysfunction in Chronic TMD

Opposite effects of mu and delta opioid receptor agonists on excitatory propagation induced in rat somatosensory and insular cortices by dental pulp stimulation

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