Neurons in the area of human thalamic nucleus ventralis caudalis respond to painful heat stimuli

Lenz, Frederick A.; Seike, Masato; Lin, Yu-Tao; Baker, Frank; Rowland, L. H.; Gracely, Richard H.; Richardson, Russell T.

doi:10.1016/0006-8993(93)91433-s

Cited by 133 publications

(41 citation statements)

References 33 publications

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“…Structures within and behind Vc contain both neurons that respond to nonpainful heat (Lenz et al, 1993b;Lee et al, 1999) and sites at which stimulation commonly evokes nonpainful heat sensations (Lenz et al, 1993a;Ohara and Lenz, 2003). In view of the present results, these previous studies suggest that the sensation of nonpainful heat is mediated through structures that are located posterior to Vc.…”

Section: Implications For Sensory Functions Mediated Through the Sttsupporting

confidence: 63%

“…In these regions, neurons respond to painful and nonpainful cold, and microstimulation may evoke the sensation of cold or cold pain (Lenz et al, 1993b;Davis et al, 1999;Lee et al, 1999;Ohara and Lenz, 2003). The present lesion results suggest that small lesions of posterior Vc are sufficient to alter cold pain sensation, and larger lesions of Vc are required to impair cold sensation.…”

Section: Implications For Sensory Functions Mediated Through the Sttmentioning

confidence: 58%

“…If the volume of the lesion in Vc is Ͻ16%, extension of the lesion posterior to Vc with a volume Ն17% is sufficient to impair the sensation of cool or cold pain (Table 4). Human anatomic and physiologic studies have demonstrated the presence of thermal and pain-signaling pathways within the posterior aspect of Vc and within nuclei that are located posterior to Vc (Mehler, 1962;Lenz et al, 1993b;Ohara and Lenz, 2003). This lesion volume-dependent impairment of sensations may be related to the monkey anatomic (Jones et al, 1982;Rausell et al, 1992;Patel et al, 2006) and human psychophysical subnuclear divisions (or elements) of modality specificity within Vc.…”

Section: Dimensions Of Lesions Required To Impair Perceptionmentioning

confidence: 99%

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Lesions Limited to the Human Thalamic Principal Somatosensory Nucleus (Ventral Caudal) Are Associated with Loss of Cold Sensations and Central Pain

et al. 2007

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Central pain is neuropathic pain resulting from a lesion of the CNS, such as a stroke [poststroke central pain (CPSP)]. Lesions involving the posterior thalamus lead to reduction or loss of sensation and to CPSP, although the responsible nuclei have not been identified. We now examine the hypotheses that thalamic lesions must extend posterior to the ventral caudal nucleus (Vc) and include ventral medial posterior nucleus (VMpo), to result in loss of cold sensibility and CPSP. Patients with small thalamic strokes associated with CPSP were evaluated by atlas-based mapping of magnetic resonance imaging scans, and by somatosensory testing. All lesions involved posterior Vc; two lesions also involved nuclei posterior to Vc, but not VMpo. All patients tested had alterations of cold pain sensation and tactile sensation, as measured by von Frey hairs. Three patients had altered cool sensation, and the patient with the least involvement of Vc had normal cool thresholds, suggesting that a critical volume of Vc must be involved before cool sensation is impaired. Perception of warm was impaired only in lesions involving nuclei posterior to Vc. Heat pain perception was never affected. In a subject with cold allodynia, a single-subject protocol PET study measured the responses to immersion of either hand in a 20°C waterbath. The scan during stimulation of the affected hand was characterized by intense activation of contralateral sensorimotor cortex. Therefore, there are modality-specific subnuclear structures in the posterior thalamus, but lesions of Vc not involving VMpo are sufficient to impair cold sensibility and to produce CPSP.

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Section: Implications For Sensory Functions Mediated Through the Sttsupporting

confidence: 63%

Section: Implications For Sensory Functions Mediated Through the Sttmentioning

confidence: 58%

Section: Dimensions Of Lesions Required To Impair Perceptionmentioning

confidence: 99%

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Lesions Limited to the Human Thalamic Principal Somatosensory Nucleus (Ventral Caudal) Are Associated with Loss of Cold Sensations and Central Pain

et al. 2007

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“…Neurological examination, including a standard sensory testing protocol (Lenz et al 1993), disclosed no abnormality in any patient, and structural brain magnetic resonance images were normal. All seizure medications were discontinued for 36 h after the implantation of the electrodes.…”

Section: Subjectsmentioning

confidence: 94%

Dipole Source Analyses of Early Median Nerve SEP Components Obtained From Subdural Grid Recordings

Baumgärtner

Vogel

Ohara

et al. 2010

Journal of Neurophysiology

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Baumgärtner U, Vogel H, Ohara S, Treede RD, Lenz FA. Dipole source analyses of early median nerve SEP components obtained from subdural grid recordings. J Neurophysiol 104: 3029 -3041, 2010. First published September 22, 2010 doi:10.1152/jn.00116.2010. The median nerve N20 and P22 SEP components constitute the initial response of the primary somatosensory cortex to somatosensory stimulation of the upper extremity. Knowledge of the underlying generators is important both for basic understanding of the initial sequence of cortical activation and to identify landmarks for eloquent areas to spare in resection planning of cortex in epilepsy surgery. We now set out to localize the N20 and P22 using subdural grid recording with special emphasis on the question of the origin of P22: Brodmann area 4 versus area 1. Electroencephalographic dipole source analysis of the N20 and P22 responses obtained from subdural grids over the primary somatosensory cortex after median nerve stimulation was performed in four patients undergoing epilepsy surgery. Based on anatomical landmarks, equivalent current dipoles of N20 and P22 were localized posterior to (n ϭ 2) or on the central sulcus (n ϭ 2). In three patients, the P22 dipole was located posterior to the N20 dipole, whereas in one patient, the P22 dipole was located on the same coordinate in anterior-posterior direction. On average, P22 sources were found to be 6.6 mm posterior [and 1 mm more superficial] compared with the N20 sources. These data strongly suggest a postcentral origin of the P22 SEP component in Brodmann area 1 and render a major precentral contribution to the earliest stages of processing from the primary motor cortex less likely.

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“…Several hypotheses have been proposed: a spinothalamic deficit (43)(44), thalamic hyperactivity or loss of thalamic inhibition by lesions of the corticothalamic fibres (45)(46)(47)(48)(49). The mechanism by which ketamine produces analgesia in CPSP is also hypothetical.…”

Section: Pain Res Manage Vol 2 No 2 Summer 1997 97mentioning

confidence: 99%

Preliminary Report on the Effect of Ketamine in Patients with Central Pain

Rostaing-Rigatti

Césaro

Nǵuyen

et al. 1997

Pain Research and Management

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C entral poststroke pain (CPSP) is a chronic neuropathic pain syndrome commonly resistant to pharmacological treatments and techniques. Allodynia, dysesthesia, hyperalgesia and sensory loss are frequently noticed in patients suffering from CPSP (1-4). In peripheral neuropathic pain, allodynia and hyperalgesia are symptoms related to plastic changes within the nervous system, resulting in peripheral and spinal cord sensitization (5-8) that could be mediated by N-methyl-D-aspartate (NMDA) receptor stimulation (9-17). This preliminary open prospective study reports on the effect of ketamine, an N-methyl-D-aspartate (NMDA)-receptor noncompetitive antagonist, in five patients suffering from central poststroke pain (CPSP). Patients were evaluated at rest on a visual analogue scale (VAS) graded from 0 to 10. Pain measurement was repeated at 15 and 30 mins following intravenous administration of 0.15 to 0.25 mg/kg ketamine and then every 30 mins for 6 h. Pain evoked by light touch or cold stimulation was also measured in three patients at those times. Patients were monitored for arterial pressure, heart rate, sedation and side effects during the study. Ketamine provided a significant improvement in pain at rest and in evoked pain. A 51% to 84% decrease in the VAS score for pain at rest was observed within 60 to 180 mins. Satisfactory pain relief (more than 50% decrease in the VAS score) lasted for 150 to 210 mins. Two patients had a prolonged improvement over two or three days. Arterial pressure and heart rate did not change significantly. Mild or moderate sedation was noticed in all patients for 20 to 30 mins. These results suggest that blockade of NMDA receptors may provide pain relief in patients suffering from CPSP. Key Words: Central pain, Central poststroke pain, Ketamine, N-methyl-D-aspartate (NMDA) antagonists, Thalamic painEtude preliminarie : Effet de la ketamine chez des patients souffrant de douleurs neuropathiques d'origine centrale RÉSUMÉ : Cette étude prospective ouverte porte sur l'effet de la kéta-mine, un antagoniste des récepteurs N-methyl-D-aspartate (NMDA), non compétitif, chez cinq patients souffrant de douleurs neuropathiques centrales après accident vasculaire cérébral, ischémique ou hémorragique. La douleur est évaluée sur une échelle visuelle analgique (EVA) de 0 à 10 avant l'injection, puis 15 et 30 minutes après l'administration intraveineuse de 0,15 à 0,25 mg/kg de kétamine, puis toutes les 30 minutes pendant 6 heures. La douleur évoquée au toucher ou au froid est également évaluée chez 3 patients, avec la même séquence. La pression artérielle, la fréquence cardiaque, la sédation et les effets secondaires sont surveillés pendant la durée de l'étude. La kétamine entraîne use diminution significative de la douleur spontanée et de la douleur évoquée. Un effet antalgique maximal de 51% à 84% est observé entre 60 et 180 minutes après l'administration de kétamine. 3 patients ont un effet antalgique satisfaisant de plus de 50% pendant 150 à 210 minutes. 2 patients ont un post-effet de 2 à 3 jours. ...

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Neurons in the area of human thalamic nucleus ventralis caudalis respond to painful heat stimuli

Cited by 133 publications

References 33 publications

Lesions Limited to the Human Thalamic Principal Somatosensory Nucleus (Ventral Caudal) Are Associated with Loss of Cold Sensations and Central Pain

Lesions Limited to the Human Thalamic Principal Somatosensory Nucleus (Ventral Caudal) Are Associated with Loss of Cold Sensations and Central Pain

Dipole Source Analyses of Early Median Nerve SEP Components Obtained From Subdural Grid Recordings

Preliminary Report on the Effect of Ketamine in Patients with Central Pain

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