FoIIow-Up Results of Centromedian Thalamotomy for Central Pain

Niizuma, H; Kwak, R; Ikeda, Shunichiro; Ohyama, Hideki; Suzuki, Jirô; Saso, Shunichi

doi:10.1159/000101618

Cited by 11 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When Hariz and Bergenheim [7] compared the results of lesioning versus DBS of the CM, they found ablative surgery to be more effective for central pain, while DBS was better for deafferentation pain. This is somewhat in contrast to the findings of Niizuma et al [127]. CM thalamotomy in patients suffering from central pain after ischemic thalamic infarction yielded more than 50% pain relief in 9 of 18 patients soon after operation.…”

Section: Periventricular Greycontrasting

confidence: 89%

Center Median-Parafascicular Complex and Pain Control

Weigel

Krauss²

2004

Stereotact Funct Neurosurg

107

View full text Add to dashboard Cite

The center median-parafascicular (CM-Pf) complex, which constitutes the major portion of the intralaminar thalamus in man, has long been known to be involved in the processing of pain under normal and pathological conditions. Yet, these ‘forgotten’ nuclei with their rich connectivity to other thalamic nuclei, the basal ganglia and cortical areas have received only relatively little attention over the past two decades. With regard to the recent reinterest in functional stereotactic neurosurgery as a treatment option for chronic refractory pain, the CM-Pf complex has been reconsidered as a target. This review provides a systematic overview on the current knowledge about the anatomy and connectivity of the CM-Pf complex, neurophysiological studies, and on concepts of its role in pain processing under various conditions. We also review the previous experience with ablative surgery and deep brain stimulation of the CM-Pf complex. Studies in men and experimental animals indicate that the CM-Pf complex is part of a medial pain system, which appears to be involved primarily in affective and motivational dimensions of pain. Single-unit recordings from the CM-Pf complex have shown that the activity of CM-Pf cells is modified by painful stimuli. Under pathological conditions, bursting firing patterns and altered discharge rates were found. Thalamotomies targeting at the CM-Pf complex yielded beneficial results for chronic pain, but interpretation of the results is limited. With bifocal deep brain stimulation, short-term effects of CM-Pf stimulation were superior to those of somatosensory thalamic stimulation in neuropathic pain. There is evidence, that the CM-Pf complex might also be involved in the mediation of the beneficial effects of somatosensory thalamic stimulation and periventricular grey stimulation.

show abstract

Section: Periventricular Greycontrasting

confidence: 89%

Center Median-Parafascicular Complex and Pain Control

Weigel

Krauss²

2004

Stereotact Funct Neurosurg

107

View full text Add to dashboard Cite

show abstract

“…The decision to em ploy com bined antero-m edial and C M -PF lesions in these cases was m ade because relief of pain after pulvinotom y is around 66% 1,11 and 56± 66% after C M -PF lesioning. 1,15 Laitenin also states th at for successful pain relief after C M lesioning alone à large' lesion is required. 1 It was, therefore, anticipated that com bined, sm aller lesions m ay be m ore effect than a single lesion, without any increase in potential side-effects.…”

Section: Discussionmentioning

confidence: 99%

“…1,15 For m ost patients with pain due to m alignant disease that requires thalam otom y death will have occurred by this Br J Neurosurg Downloaded from informahealthcare.com by Flinders University of South Australia on 01/05/15…”

Section: Discussionmentioning

confidence: 99%

CT-guided stereotactic antero-medial pulvinotomy and centromedian-parafascicular thalamotomy for intractable malignant pain

Whittle

Jenkinson²

1995

British Journal of Neurosurgery

View full text Add to dashboard Cite

show abstract

“…Pulvinar [59][60][61] Posteromedial hypothalamus 62,63 Hypophysis 64 CM-Pf 38,39,65 Vpm 66 CM-Pf, centrum medianum-parafascicularis; Vpm, nucleus ventralis posteromedialis.…”

Section: History Of Ablative Central Nervous System Proceduresmentioning

confidence: 99%

“…37 The following coordinates have been used for targeting sites within the medial thalamus: 7 to 11 mm posterior to the midpoint of the AC-PC line, 6 to 10 mm lateral, and 1 mm below to 2 mm above the level of the AC-PC line. 38,39 Alternatively, initial targeting of Vc (Vpl) can be performed by selecting a point 14 to 15 mm lateral to the midline (corresponding to upper limb representation) at the level of the PC. Electrode trajectories are made through the thalamus in a parasagittal plane.…”

Section: Localizationmentioning

confidence: 99%