Keifer Orion Paul, Riley Jonathan P, Boulis Nicholas M
MD/PhD Program, School of Medicine, Emory University, Suite 375-B, 1648 Pierce Drive, Atlanta, GA 30322, USA.
Department of Neurosurgery, Emory University, 1365-B Clifton Road Northeast, Suite 2200, Atlanta, GA 30322, USA.
Neurosurg Clin N Am. 2014 Oct;25(4):671-92. doi: 10.1016/j.nec.2014.07.009.
For over half a century, neurosurgeons have attempted to treat pain from a diversity of causes using acute and chronic intracranial stimulation. Targets of stimulation have included the sensory thalamus, periventricular and periaqueductal gray, the septum, the internal capsule, the motor cortex, posterior hypothalamus, and more recently, the anterior cingulate cortex. The current work focuses on presenting and evaluating the evidence for the efficacy of these targets in a historical context while also highlighting the major challenges to having a double-blind placebo-controlled clinical trial. Considerations for pain research in general and use of intracranial targets specifically are included.
半个多世纪以来，神经外科医生一直试图通过急性和慢性颅内刺激来治疗各种原因引起的疼痛。刺激靶点包括感觉丘脑、脑室周围和导水管周围灰质、隔膜、内囊、运动皮层、下丘脑后部，以及最近的前扣带回皮层。当前的工作重点是在历史背景下展示和评估这些靶点有效性的证据，同时突出进行双盲安慰剂对照临床试验的主要挑战。文中还包括了一般疼痛研究的考量因素，特别是颅内靶点的使用。
