Document Detail


Neuromodulation of the cingulum for neuropathic pain after spinal cord injury. Case report.
MedLine Citation:
PMID:  17639889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The authors present a case in which high-frequency electrical stimulation of the cingulum using standard deep brain stimulation (DBS) technology resulted in pain relief similar to that achieved with cingulotomy and superior to that achieved with periventricular gray matter (PVG) stimulation. This patient had a complete spinal cord injury at the C-4 level and suffered from medically refractory neuropathic pain. He underwent placement of bilateral cingulum and unilateral PVG DBS electrodes and a 1-week blinded stimulation trial prior to permanent implantation of a pulse generator. During the stimulation trial, the patient's pain level was assessed using a visual analog scale, and pain medication usage was recorded. During this period the patient was blinded to stimulation parameters. Stimulation of the cingulum provided better pain control than PVG stimulation or medication alone. The authors believe that cingulum stimulation can benefit patients with severe neuropathic pain that is refractory to other treatments. Advantages over cingulotomy include reversibility and the ability to adjust stimulation parameters for optimum efficacy.
Authors:
John Spooner; Hong Yu; Chris Kao; Karl Sillay; Peter Konrad
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  107     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-20     Completed Date:  2007-08-10     Revised Date:  2009-04-07    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  169-72     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurological Surgery, Section of Functional Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2380, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Deep Brain Stimulation / methods*
Electrodes, Implanted
Gyrus Cinguli / physiology*,  radiography
Humans
Male
Pain / etiology*,  therapy*
Spinal Cord Injuries / complications*
Tomography, X-Ray Computed
Ventral Thalamic Nuclei / physiology,  radiography
Comments/Corrections
Comment In:
J Neurosurg. 2009 Mar;110(3):607
J Neurosurg. 2009 Mar;110(3):607   [PMID:  19249939 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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