Long-term results of motor cortex stimulation in the treatment of chronic, intractable neuropathic pain.

BACKGROUND/OBJECTIVES: Although motor cortex stimulation (MCS) has been used for more than 20 years in the treatment of chronic neuropathic pain, there is still a debate about the efficacy of MCS.

METHODS

To investigate the long-term results and the factors associated with the long-term success of chronic MCS, 21 patients who underwent MCS trial were classified as having central poststroke pain, central pain after spinal cord injury (SCI) and peripheral neuropathic pain, and we investigated the clinical factors associated with long-term success and degree of pain relief.

RESULTS

Of the 21 patients, 16 (76.2%) had a successful trial and underwent chronic MCS. In the long-term follow-up (53 ± 39 months), only the diagnosis (central poststroke pain and peripheral neuropathic pain) was associated with long-term success defined as >30% pain relief compared with baseline (p < 0.05, χ(2) test). The difference in pain relief was not significant in patients having SCI pain (p > 0.05, 1-way ANOVA). The other variables did not show any significant influence in the long-term success and degree of pain relief (p > 0.05, 1-way ANOVA).

CONCLUSIONS

MCS was more effective in the treatment of chronic neuropathic pain of central poststroke pain and peripheral neuropathic pain types than in the treatment of SCI pain in the long-term follow-up.