BACKGROUND: Spinal cord stimulation (SCS) is an effective alternative treatment in patients with chronic neuropathic pain and mainly radicular distribution. The aim of this prospective study was to investigate changes in BOLD signal with fMRI during active SCS and to correlate the results with the clinical pain intensity, measured with a visual analogue scale (VAS). PATIENTS AND METHODS: Three patients with failed back surgery syndrome were tested during the clinical trial of SCS. A first fMRI was performed with marked pain and a high VAS score. Before the second fMRI a therapeutic stimulation phase with pain reduction was carried out. RESULTS: With high pain levels SCS activated the cingulate gyrus, thalamus, prefrontal cortex, supplementary motor area and postcentral gyrus. After pain reduction, SCS did not elicit these activations in the second fMRI, using the same stimulation parameters. CONCLUSIONS: In patients with chronic neuropathic pain and high VAS levels, SCS elicited BOLD activation in the cingulate gyrus, thalamus, prefrontal cortex, and primary and secondary somatosensory area. Pain reduction by SCS resulted in a reduction of functional activity in these areas as revealed by follow-up fMRI.
BACKGROUND: Spinal cord stimulation (SCS) is an effective alternative treatment in patients with chronic neuropathic pain and mainly radicular distribution. The aim of this prospective study was to investigate changes in BOLD signal with fMRI during active SCS and to correlate the results with the clinical pain intensity, measured with a visual analogue scale (VAS). PATIENTS AND METHODS: Three patients with failed back surgery syndrome were tested during the clinical trial of SCS. A first fMRI was performed with marked pain and a high VAS score. Before the second fMRI a therapeutic stimulation phase with pain reduction was carried out. RESULTS: With high pain levels SCS activated the cingulate gyrus, thalamus, prefrontal cortex, supplementary motor area and postcentral gyrus. After pain reduction, SCS did not elicit these activations in the second fMRI, using the same stimulation parameters. CONCLUSIONS: In patients with chronic neuropathic pain and high VAS levels, SCS elicited BOLD activation in the cingulate gyrus, thalamus, prefrontal cortex, and primary and secondary somatosensory area. Pain reduction by SCS resulted in a reduction of functional activity in these areas as revealed by follow-up fMRI.
Authors: James W Ibinson; Robert H Small; Antonio Algaze; Cynthia J Roberts; David L Clark; Petra Schmalbrock Journal: Anesthesiology Date: 2004-10 Impact factor: 7.892
Authors: A R Rezai; A M Lozano; A P Crawley; M L Joy; K D Davis; C L Kwan; J O Dostrovsky; R R Tasker; D J Mikulis Journal: J Neurosurg Date: 1999-03 Impact factor: 5.115
Authors: B Linderoth; C O Stiller; L Gunasekera; W T O'Connor; J Franck; B Gazelius; E Brodin Journal: Stereotact Funct Neurosurg Date: 1993 Impact factor: 1.875
Authors: M Moens; S Sunaert; P Mariën; R Brouns; A De Smedt; S Droogmans; P Van Schuerbeek; R Peeters; J Poelaert; B Nuttin Journal: Neuroradiology Date: 2012-09-02 Impact factor: 2.804
Authors: Richard L Witkam; Constantinus F Buckens; Johan W M van Goethem; Kris C P Vissers; Dylan J H A Henssen Journal: Insights Imaging Date: 2022-07-15
Authors: Maarten Moens; Peter Mariën; Raf Brouns; Jan Poelaert; Ann De Smedt; Ronald Buyl; Steven Droogmans; Peter Van Schuerbeek; Stefan Sunaert; Bart Nuttin Journal: Neuroradiology Date: 2013-05-12 Impact factor: 2.804
Authors: Thomas Kinfe; Nico von Willebrand; Andreas Stadlbauer; Michael Buchfelder; Thomas L Yearwood; Sajjad Muhammad; Shafqat R Chaudhry; Sascha Gravius; Thomas Randau; Klemens Winder; Christian Maihöfner; Nadine Gravius; Walter Magerl Journal: J Transl Med Date: 2020-10-21 Impact factor: 5.531