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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Pain01:20

Pain

Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
Nociception01:44

Nociception

Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain. Thus, pain helps the...

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The Sciatic Nerve Cuffing Model of Neuropathic Pain in Mice
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Chasing map plasticity in neuropathic pain.

Dirk De Ridder1, Sven Vanneste, Koen Van Laere

  • 1BRAI²N and Department of Neurosurgery, University Hospital Antwerp, Antwerp, Belgium; Department of Translational Neuroscience, Faculty of Medicine, University of Antwerp, Antwerp, Belgium; Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

World Neurosurgery
|December 19, 2012
PubMed
Summary
This summary is machine-generated.

Somatosensory cortex stimulation shows promise for neuropathic pain. Functional imaging like fMRI and PET revealed new targets for pain relief in a patient with trigeminal anesthesia dolorosa.

Keywords:
ADAnesthesia dolorosaBOLDBlood-oxygen-level dependenceEyeFunctional magnetic resonance imagingIPGImplantInternal pulse generatorPETPerceptionPhantomPositron emission tomographyPrimary somatosensory cortexSISIISecondary somatosensory cortexSomatosensory reorganizationTMSTranscranial magnetic stimulationfMRI

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Area of Science:

  • Neurology
  • Pain Management
  • Neuroimaging

Background:

  • Somatosensory cortex stimulation is a proposed treatment for neuropathic deafferentation pain.
  • The approach involves identifying pain-associated cortical activity using functional magnetic resonance imaging (fMRI).
  • fMRI-guided transcranial magnetic stimulation (TMS) can transiently suppress pain, guiding the placement of extradural electrodes.

Observation:

  • A patient with trigeminal anesthesia dolorosa experienced new pain after surgery, and reprogramming the existing electrode was ineffective.
  • Artifacts from the electrode prevented repeat fMRI; thus, positron emission tomography (PET) was used to identify new stimulation targets.
  • These novel targets were located anterior and posterior to the original electrode site.

Findings:

  • Combining fMRI and PET imaging revealed continued map plasticity in the somatosensory cortex.
  • Two new electrodes were implanted at the novel targets identified by PET.
  • Pain was effectively controlled with the new electrodes in a placebo-controlled manner.

Implications:

  • Functional imaging (fMRI and PET) can guide pathophysiology-based somatosensory cortex stimulation.
  • This approach may offer new therapeutic targets for managing progressive somatosensory deafferentation pain.
  • Demonstrates the potential for adaptive neuromodulation strategies in chronic pain management.