Saitoh Youichi, Maruo Tomoyuki, Yokoe Masaru, Matsuzaki Taiga, Sekino Masaki
Annu Int Conf IEEE Eng Med Biol Soc. 2013;2013:6163-6. doi: 10.1109/EMBC.2013.6610960.
To assess the pain-relieving effects of motor cortex electrical stimulation (MCS) and the predictive factors retrospectively.
Thirty-four patients with intractable neuropathic pain underwent MCS; 19 patients had cerebral lesions, and 15 had non-cerebral lesions. In selected 12 patients, test electrodes were implanted within the central sulcus and on the precentral gyrus. Twelve patients received both MCS and repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex.
Pain reduction of >50% was observed in 12 of 32 (36%) patients with >12 months follow-ups (2 patients were excluded because of short follow-up). In 10 of the 12 patients who received test electrodes within the central sulcus and on the precentral gyrus, the optimal stimulation was MCS within the central sulcus. In 4 of these (40%) patients, positive effects were maintained at follow-ups. The pain reduction of rTMS significantly correlated with that of MCS during test stimulation.
The test stimulation within the central sulcus was more effective than that of the precentral gyrus. In the selected patients, chronic stimulation within the central sulcus did not significantly improve long-term results. Repeated rTMS seems to be same effective as MCS.
回顾性评估运动皮层电刺激（MCS）的止痛效果及预测因素。
34例顽固性神经性疼痛患者接受了MCS；19例有脑部病变，15例有非脑部病变。在选定的12例患者中，将测试电极植入中央沟内和中央前回。12例患者同时接受了MCS和初级运动皮层的重复经颅磁刺激（rTMS）。
在32例随访超过12个月的患者中，12例（36%）疼痛减轻>50%（2例因随访时间短被排除）。在12例在中央沟内和中央前回植入测试电极的患者中，10例的最佳刺激是中央沟内的MCS。其中4例（40%）患者在随访期间维持了积极效果。测试刺激期间，rTMS的疼痛减轻与MCS的疼痛减轻显著相关。
中央沟内的测试刺激比中央前回更有效。在选定的患者中，中央沟内的慢性刺激并未显著改善长期效果。重复rTMS似乎与MCS效果相同。
