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Chronic motor cortex stimulation for phantom limb pain: a functional magnetic resonance imaging study: technical case
F E Roux1, D Ibarrola, Y Lazorthes
1Department of Neurosurgery, H pital Rangueil, Toulouse, France. roux.f2@chu-toulouse.fr
Neurosurgery
|March 29, 2001
Summary
Chronic motor cortex stimulation effectively reduced phantom limb pain and phenomena in an amputee. Functional magnetic resonance imaging (fMRI) guided electrode placement and revealed pain control mechanisms.
Area of Science:
- Neurosurgery
- Pain Management
- Neuroimaging
Background:
- Chronic motor cortex stimulation is effective for central and neuropathic trigeminal pain.
- Phantom limb pain (PLP) and phenomena present significant management challenges.
Observation:
- A patient with a 2-year history of phantom limb pain post-amputation experienced phenomena of voluntary phantom hand movement.
- Preoperative functional magnetic resonance imaging (fMRI) identified cortical activation areas related to the stump, shoulder, and "virtual" hand.
Findings:
- Motor cortex stimulation resulted in a 70% reduction in phantom limb pain.
- fMRI guided electrode placement via a frameless stereotactic device.
- Postoperative fMRI demonstrated inhibitory effects on sensorimotor cortex and contralateral motor/sensory cortices.
Implications:
- Chronic motor cortex stimulation is a viable treatment for phantom limb pain and phenomena.
- fMRI integration enhances surgical precision for electrode placement.
- fMRI provides insights into pain control mechanisms and cortical reorganization in PLP.