Paper Info
Title
Modulation of neuronal activity after spinal cord stimulation for neuropathic pain; H215O PET study
Abstract
Spinal cord stimulation (SCS) is an effective therapy for chronic neuropathic pain. However, the detailed mechanisms underlying its effects are not well understood. Positron emission tomography (PET) with H215O was applied to clarify these mechanisms. Nine patients with intractable neuropathic pain in the lower limbs were included in the study. All patients underwent SCS therapy for intractable pain, which was due to failed back surgery syndrome in three patients, complex regional pain syndrome in two, cerebral hemorrhage in two, spinal infarction in one, and spinal cord injury in one. Regional cerebral blood flow (rCBF) was measured by H215O PET before and after SCS. The images were analyzed with statistical parametric mapping software (SPM2). SCS reduced pain; visual analog scale values for pain decreased from 76.1±25.2 before SCS to 40.6±4.5 after SCS (mean±SE). Significant rCBF increases were identified after SCS in the thalamus contralateral to the painful limb and in the bilateral parietal association area. The anterior cingulate cortex (ACC) and prefrontal areas were also activated after SCS. These results suggest that SCS modulates supraspinal neuronal activities. The contralateral thalamus and parietal association area would regulate the pain threshold. The ACC and prefrontal areas would control the emotional aspects of intractable pain, resulting in the reduction of neuropathic pain after SCS.
Year
DOI
Venue
2010
10.1016/j.neuroimage.2009.10.054
NeuroImage
Keywords
DocType
Volume
Neuropathic pain,Spinal cord stimulation,Regional cerebral blood flow
Journal
49
Issue
ISSN
Citations 
3
1053-8119
0
PageRank 
References 
Authors
0.34
0
10
Name
Order
Citations
PageRank
Haruhiko Kishima1205.00
Youichi Saitoh2317.25
Satoru Oshino3163.09
Koichi Hosomi400.34
Mohamed Ali500.34
Tomoyuki Maruo600.68
Masayuki Hirata75413.79
Tetsu Goto8124.14
Takufumi Yanagisawa9216.27
Masahiko Sumitani1021.40