Motor cortex stimulation for long-term relief of chronic neuropathic pain: A 10 year experience

@article{Rasche2006MotorCS,
  title={Motor cortex stimulation for long-term relief of chronic neuropathic pain: A 10 year experience},
  author={Dirk Rasche and Marc Ruppolt and Christoph Stippich and Andreas Unterberg and Volker M. Tronnier},
  journal={Pain},
  year={2006},
  volume={121},
  pages={43-52}
}
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167 Citations
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6
Background Citations
35
Methods Citations
8
Results Citations
3

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167 Citations

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Treatment of Central Deafferentation and Trigeminal Neuropathic Pain by Motor Cortex Stimulation: Report of a Series of 20 Patients.
TLDR
MCS is an effective treatment modality for central neuropathic pain and trigeminal pain with low morbidity and mortality and future studies are necessary to evaluate and optimize this treatment option in more detail.
Long-term effect of motor cortex stimulation in patients suffering from chronic neuropathic pain: An observational study
TLDR
MCS seems a promising therapeutic option for patients with refractory pain syndromes of central origin with a 3-year follow-up, with a significant difference in response to MCS.
[Results of motor cortex stimulation in the treatment of chronic pain syndromes].
TLDR
Chronic epidural MCS is an effective and safety method for the treatment of some chronic neurogenic medically-refractory pain syndromes and further research is necessary to specify the patient selection criteria and the MCS efficacy predictors.
Long-Term Results of Motor Cortex Stimulation in the Treatment of Chronic, Intractable Neuropathic Pain
TLDR
MCS was more effective in the treatment of chronic neuropathic pain of central poststroke pain and peripheral neuropathicPain types than in the Treatment of SCI pain in the long-term follow-up.
Clinical Significance of Invasive Motor Cortex Stimulation for Trigeminal Facial Neuropathic Pain Syndromes.
TLDR
MCS is an additional therapeutic option for patients with refractory chronic TNP, and significant long-term pain suppression can be achieved, as a prospective, noncontrolled clinical trial.
Long-Term Follow-Up of Motor Cortex Stimulation for Neuropathic Pain in 23 Patients
TLDR
In this study, MCS failed to provide long-term pain control for neuropathic pain, and means must be developed to overcome the problems in this promising technique.
Motor Cortex Stimulation for Neuropathic Pain: A Randomized Cross-over Trial
TLDR
It is suggested that a healthy degree of skepticism is warranted when considering this invasive therapy for upper extremity pain syndromes and that previous studies may have been skewed by placebo effects, or the authors' by nocebo.
Electrical or repetitive transcranial magnetic stimulation of primary motor cortex for intractable neuropathic pain
TLDR
The test stimulation within the central sulcus was more effective than that of the precentral gyrus and Repeated rTMS seems to be same effective as MCS.
Simultaneous Trial of Deep Brain and Motor Cortex Stimulation in Chronic Intractable Neuropathic Pain
TLDR
Considering the initial success rate and the less invasive nature of epidural MCS compared with DBS, it is thought that MCS would be a more reasonable initial means of treatment for chronic intractable neuropathic pain.
Motor cortex stimulation for the treatment of refractory peripheral neuropathic pain.
TLDR
The results of the first randomized controlled trial using chronic MCS in peripheral neuropathic pain suggest that the indication of MCS might be extended to various types of refractory, chronic peripheral pain beyond trigeminal neuropathicpain.
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References

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Motor cortex stimulation for chronic neuropathic pain: a preliminary study of 10 cases
Chronic precentral stimulation in trigeminal neuropathic pain
SummaryThe results of Deep Brain Stimulation in deafferentation pain syndromes, in particular in thalamic pain, indicate that excellent long-term pain relief can hardly ever be achieved. We report 7…
Chronic motor cortex stimulation in the treatment of central and neuropathic pain. Correlations between clinical, electrophysiological and anatomical data
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TLDR
The effect of stimulation on pain and capability of producing muscle twitch disappeared simultaneously in these cases and the effect reappeared after the revisions, indicating that appropriate stimulation of the motor cortex is definitely necessary for obtaining satisfactory pain control in these patients.
Motor cortex stimulation for neuropathic facial pain
TLDR
A long-term follow-up of two patients with unilateral facial neuropathic pain due to idiopathic trigeminal neuropathy or to surgical trauma to the glossopharyngeal nerve is presented, and electrical stimulation of the motor cortex with a quadripolar electrode contralateral to the painful area of the face resulted in immediate analgesia with more than 50% pain reduction.
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TLDR
While stimulation of the first- to third-order sensory neurons at the level of the thalamic relay nucleus or below cannot bring about good pain inhibition in patients withThalamic pain, activation of hypothetical fourth- order sensory neurons through precentral stimulation may be able to inhibit deafferented nociceptive neurons within the cortex.
Motor cortex stimulation for central and peripheral deafferentation pain. Report of eight cases.
TLDR
Patients with peripheral deafferentation pain, including two with phantom-limb pain and two with brachial plexus injury, attained pain relief from motor cortex stimulation, with excellent results in two cases.
Poststroke pain control by chronic motor cortex stimulation: neurological characteristics predicting a favorable response.
TLDR
The findings suggest that the pain control afforded by MC stimulation requires neuronal circuits that are maintained by the presence of intact corticospinal tract neurons originating from the MC.
Motor Cortex Stimulation for Central and Neuropathic Facial Pain: A Prospective Study of 10 Patients and Observations of Enhanced Sensory and Motor Function during Stimulation
TLDR
These results provide further support for the use of motor cortex stimulation in facial neuropathic pain and document pain improvement as measured by multidimensional scales.
[Treatment of central and neuropathic facial pain by chronic stimulation of the motor cortex: value of neuronavigation guidance systems for the localization of the motor cortex].
TLDR
The neuronavigator localization and guidance technique proved to be most useful identifying the appropriate portion of the motor gyrus which allowed the establishment of reliable correlations between electrophysiological-clinical and anatomical data which may be used to improve the clinical results and possibly to extend the indications of this technique.
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