Pain perception in man after long term spinal cord stimulation

Doerr, M.; Krainick, J.-U.; Thoden, U.

doi:10.1007/bf00312987

Cited by 28 publications

(29 citation statements)

References 16 publications

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“…Stimulation of the cerebellum increased pain thresholds in monkeys (Siegel and Wepsic, 1974). Patients perceived roughly the same level of pain during SCS as they did during the absence of SCS, corroborating some of the previous studies which reported no changes in acute pain perception during short-term SCS (Lindblom and Meyerson, 1975;Doerr et al, 1978). The comparator function of the cerebellum would account for the relatively small cerebellar activations seen during either heat pain or spinal cord stimulation alone.…”

Section: Interaction Between Acute Experimental Pain and Spinal Cord supporting

confidence: 82%

Functional magnetic resonance imaging of cerebral activation during spinal cord stimulation in failed back surgery syndrome patients

Stančák

Kozák

Vrba

et al. 2008

European Journal of Pain

101

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Spinal cord stimulation (SCS) consisting of electrical stimulation of the dorsal spinal cord using epidural electrodes has been shown to relieve chronic neuropathic pain. To analyze the cerebral activation patterns related to SCS, and to evaluate the effects of SCS on the processing of acute experimental pain, we performed functional magnetic resonance imaging (fMRI) on eight patients suffering from failed back surgery syndrome who were also being treated with SCS for severe pain in their legs and lower back. Three types of stimulation were used, each lasting 36s: (i) SCS, (ii) heat pain (HP) applied to the leg affected by neuropathic pain, and (iii) simultaneous HP and SCS. During SCS, we found increased activation of the medial primary sensorimotor cortex somatotopically corresponding to the foot and/or perineal region, contralateral posterior insula, and the ipsilateral secondary somatosensory cortex (S2). Decreased activation was seen in the bilateral primary motor cortices and the ipsilateral primary somatosensory cortex corresponding to the shoulder, elbow and hand. Compared to separately presented HP and SCS, simultaneous HP and SCS showed statistically significant activation of the bilateral inferior temporal cortex and the ipsilateral cerebellar cortex. The activation of the primary motor cortex, insula and S2 during SCS may directly interfere with the processing of neuropathic pain. When SCS is associated with heat pain, the paralimbic association cortex and cerebellum show activation exceeding the sum of activations resulting from separate SCS and heat pain stimulation. The explanation of this could possibly rest with the continuous comparisons of simultaneous pain and somatosensory sensations occurring in a single dermatome.

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Section: Interaction Between Acute Experimental Pain and Spinal Cord supporting

confidence: 82%

Functional magnetic resonance imaging of cerebral activation during spinal cord stimulation in failed back surgery syndrome patients

Stančák

Kozák

Vrba

et al. 2008

European Journal of Pain

101

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“…The modification of evoked potentials can thus be documented at the thalamic level, although it was not seen in somatosensory evoked poten tials recorded from the scalp [7]. The present results add further verifica tion of those obtained by Modesti and Waszak [21], One particularly significant finding was the modification of median nerve evoked potentials on stimulation of the dorsal columns at the thora cic level.…”

Section: Discussionsupporting

confidence: 76%

Influence of Dorsal Column Stimulation upon Human Thalamic Somatosensory-Evoked Potentials

Gildenberg¹,

Murthy²

1980

Stereotact Funct Neurosurg

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2 patients with previously implanted dorsal column stimulators underwent basal thalamotomy for the treatment of pain, which provided the opportunity to record evoked potentials from the intralaminar (IL) and ventroposterolateral (VPL) areas of the thalamus. Short latency evoked potentials recorded from VPL were not influenced by dorsal column stimulation. However, very long latency (500 ms) potentials recorded bilaterally in IL were modified by stimulation of the dorsal columns of the spinal cord at frequencies between 20 and 40 Hz.

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“…In this connection, results of a conditioning stimulation of the dorsal column system are of interest. Blair et al [5] showed an inhibi tion of all late components by a slight DCS-stimulation, while other au thors described effects exerted on the early potentials of the SSEP [14,20], In our patients, no effect could be recorded either of a conditioning stimulation of the dorsal columns or of transcutaneous nerve stimulation of the median nerve evoked SSEP potentials [7,30].…”

Section: Discussionmentioning

confidence: 64%

Mesencephalic Chronic Electrodes in Pain Patients

Straßburg¹,

Thoden²,

Mundinger³

1979

Stereotact Funct Neurosurg

Self Cite

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Early components of lemniscal potentials after contralateral median nerve or mechanical stimulus are due to lemniscal pathways, whereas later components, after 70 msec appearing bilaterally and at higher stimulus intensities probably express extralemniscal activity. Evoked potentials in the central gray matter show much smaller amplitudes compared with somatosensory cortical evoked potentials (SSEP). The strongest component is a negative wave after 70–100 msec. Longer conditioning stimulation of the lemniscal system inhibits late components in the median nerve evoked cortical potentials. On the contrary, stimulation of the nonspecific periaqueductal gray matter produces inhibition of early components of cortical SSEP together with facilitation of late components.

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Pain perception in man after long term spinal cord stimulation

Cited by 28 publications

References 16 publications

Functional magnetic resonance imaging of cerebral activation during spinal cord stimulation in failed back surgery syndrome patients

Functional magnetic resonance imaging of cerebral activation during spinal cord stimulation in failed back surgery syndrome patients

Influence of Dorsal Column Stimulation upon Human Thalamic Somatosensory-Evoked Potentials

Mesencephalic Chronic Electrodes in Pain Patients

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