The effect of occipital nerve field stimulation on the descending pain pathway in patients with fibromyalgia: a water PET and EEG imaging study

Autor: Mark Plazier, Jan Ost, Dirk De Ridder, Shaheen Ahmed, Steven Staelens, Sarah Ceyssens, Steven Deleye, Sven Vanneste, Gaetane Stassijns, Sigrid Stroobants, Patrick Dupont
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Male
Fibromyalgia
SPINAL-CORD STIMULATION
Stimulation
PREFRONTAL CORTEX
Electroencephalography
Somatosensory system
lcsh:RC346-429
DOUBLE-BLIND
0302 clinical medicine
Occipital nerve stimulation
Neural Pathways
BRAIN
medicine.diagnostic_test
Brain
FUNCTIONAL CONNECTIVITY
General Medicine
Middle Aged
medicine.anatomical_structure
Treatment Outcome
Anesthesia
Positron emission tomography (PET)
Transcutaneous Electric Nerve Stimulation
Female
Life Sciences & Biomedicine
PLACEBO ANALGESIA
Research Article
Adult
Clinical Neurology
PARAHIPPOCAMPAL CORTEX
POSTERIOR CINGULATE CORTEX
Sensory system
Auditory cortex
03 medical and health sciences
Double-Blind Method
medicine
Humans
MODULATION
Anterior cingulate cortex
lcsh:Neurology. Diseases of the nervous system
Science & Technology
business.industry
medicine.disease
CONTEXTUAL ASSOCIATIONS
030104 developmental biology
Positron-Emission Tomography
Neurosciences & Neurology
Human medicine
Neurology (clinical)
business
030217 neurology & neurosurgery
Zdroj: BMC Neurology, Vol 18, Iss 1, Pp 1-10 (2018)
BMC Neurology
BMC neurology
ISSN: 1471-2377
0091-7176
DOI: 10.1186/s12883-018-1190-5
Popis: BACKGROUND: Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood problems. Recently, occipital nerve field stimulation (ONS) has been proposed as an effective potential treatment for fibromyalgia-related pain. The aim of this study is to unravel the neural mechanism behind occipital nerve stimulation's ability to suppress pain in fibromyalgia patients. MATERIALS AND METHODS: Seven patients implanted with subcutaneous electrodes in the C2 dermatoma were enrolled for a Positron Emission Tomography (PET) H215O activation study. These seven patients were selected from a cohort of 40 patients who were part of a double blind, placebo-controlled study followed by an open label follow up at six months. The H215O PET scans were taken during both the "ON" (active stimulation) and "OFF" (stimulating device turned off) conditions. Electroencephalogram (EEG) data were also recorded for the implanted fibromyalgia patients during both the "ON" and "OFF" conditions. RESULTS: Relative to the "OFF" condition, ONS stimulation resulted in activation in the dorsal lateral prefrontal cortex, comprising the medial pain pathway, the ventral medial prefrontal cortex, and the bilateral anterior cingulate cortex as well as parahippocampal area, the latter two of which comprise the descending pain pathway. Relative deactivation was observed in the left somatosensory cortex, constituting the lateral pain pathway as well as other sensory areas such as the visual and auditory cortex. The EEG results also showed increased activity in the descending pain pathway. The pregenual anterior cingulate cortex extending into the ventral medial prefrontal cortex displayed this increase in the theta, alpha1, alpha2, beta1, and beta2 frequency bands. CONCLUSION: PET shows that ONS exerts its effect via activation of the descending pain inhibitory pathway and the lateral pain pathway in fibromyalgia, while EEG shows activation of those cortical areas that could be responsible for descending inhibition system recruitment. TRIAL REGISTRATION: This study is registered with ClinicalTrials.gov , number NCT00917176 (June 10, 2009). ispartof: BMC NEUROLOGY vol:18 issue:1 ispartof: location:England status: published
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje