Functional magnetic resonance imaging: cerebral function alterations in subthreshold and suprathreshold spinal cord stimulation
| Autor: | Peter Van Schuerbeek, Patrice Forget, Ronald Peeters, Maarten Moens, Dirk Loeckx, Mats De Jaeger, Lisa Goudman, Ann De Smedt, Stefan Sunaert, Sander De Groote |
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| Přispěvatelé: | Faculty of Medicine and Pharmacy, Radiology, Supporting clinical sciences, Medical Imaging, Pain in Motion, Faculty of Physical Education and Physical Therapy, Anesthesiology, Clinical sciences, Physical Medicine and Rehabilitation, Neuroprotection & Neuromodulation, Neurosurgery |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
CONTROLLED PIVOTAL TRIAL
REGIONAL PAIN SYNDROME spinal cord stimulation Precuneus Stimulation BACK SURGERY SYNDROME suprathreshold stimulation Superior temporal gyrus 0302 clinical medicine Gyrus 030202 anesthesiology CONNECTIVITY Medicine BRAIN Original Research Medicine(all) lcsh:R5-920 medicine.diagnostic_test 10-KHZ HIGH-FREQUENCY NEUROPATHIC PAIN fMRI medicine.anatomical_structure frequency lcsh:Medicine (General) Functional magnetic resonance Life Sciences & Biomedicine psychological phenomena and processes Thalamus Clinical Neurology behavioral disciplines and activities MECHANISMS subthreshold 03 medical and health sciences BURST STIMULATION cerebral function alterations Journal of Pain Research Science & Technology business.industry Postcentral gyrus spinal cord Spinal cord Anesthesiology and Pain Medicine nervous system Neurosciences & Neurology business Functional magnetic resonance imaging Neuroscience 030217 neurology & neurosurgery |
| Zdroj: | Journal of Pain Research Journal of Pain Research, Vol Volume 11, Pp 2517-2526 (2018) |
| ISSN: | 1178-7090 |
| Popis: | Sander De Groote,1 Mats De Jaeger,1 Peter Van Schuerbeek,2 Stefan Sunaert,3 Ronald Peeters,3 Dirk Loeckx,4 Lisa Goudman,1,5 Patrice Forget,6 Ann De Smedt,7 Maarten Moens1,2,8 1Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; 2Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium; 3Department of Radiology, Universitair Ziekenhuis Leuven, Leuven, Belgium; 4COMETRIX, Leuven, Belgium; 5Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium; 6Department Anesthesiology, Universitair Ziekenhuis Brussel, Brussels, Belgium; 7Department of Neurology, Universitair Ziekenhuis Brussel, Brussels, Belgium; 8Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium Background and purpose: Failed back surgery syndrome (FBSS) is a common and devastating chronic neuropathic pain disorder. Conventional spinal cord stimulation (SCS) applies electrical suprathreshold pulses to the spinal cord at a frequency of 40–60 Hz and relieves pain in FBSS patients. During the last decade, two major changes have emerged in the techniques of stimulating the spinal cord: paresthesia-free or subthreshold stimulation and administration of higher frequency or higher amounts of energy to the spinal cord. Despite the positive clinical results, the mechanism of action remains unclear. A functional MRI (fMRI) study was conducted to investigate the brain alterations during subthreshold and suprathreshold stimulation at different frequencies. Methods: Ten subjects with FBSS, treated with externalized SCS, received randomly four different stimulation frequencies (4 Hz, 60 Hz, 500 Hz, and 1 kHz) during four consecutive days. At every frequency, the patient underwent sub- and suprathreshold stimulation. Cerebral activity was monitored and assessed using fMRI. Results: Suprathreshold stimulation is generally accompanied with more activity than subthreshold SCS. Suprathreshold SCS resulted in increased bilateral activation of the frontal cortex, thalamus, pre- and postcentral gyri, basal ganglia, cingulate gyrus, insula, thalamus, and claustrum. We observed deactivation of the bilateral parahippocampus, amygdala, precuneus, posterior cingulate gyrus, postcentral gyrus, and unilateral superior temporal gyrus. Conclusion: Suprathreshold stimulation resulted in greater activity (both activation and deactivation) of the frontal brain regions; the sensory, limbic, and motor cortices; and the diencephalon in comparison with subthreshold stimulation. Each type of frequency at suprathreshold stimulation was characterized by an individual activation pattern. Keywords: spinal cord stimulation, fMRI, subthreshold, suprathreshold, frequency |
| Databáze: | OpenAIRE |
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