• Der Schmerz · Nov 2005

    [Spinal cord stimulation in Failed-Back-Surgery-Syndrome. Preliminary study for the evaluation of therapy by functional magnetic resonance imaging (fMRI)].

    • D Rasche, S Siebert, C Stippich, B Kress, E Nennig, K Sartor, and V M Tronnier.
    • Neurochirurgische Klinik, Universitätsklinikum Heidelberg. dirk.rasche@med.uni-heidelberg.de
    • Schmerz. 2005 Nov 1;19(6):497-500, 502-5.

    BackgroundSpinal cord stimulation (SCS) is an effective alternative treatment in patients with chronic neuropathic pain and mainly radicular distribution. The aim of this prospective study was to investigate changes in BOLD signal with fMRI during active SCS and to correlate the results with the clinical pain intensity, measured with a visual analogue scale (VAS).Patients And MethodsThree patients with failed back surgery syndrome were tested during the clinical trial of SCS. A first fMRI was performed with marked pain and a high VAS score. Before the second fMRI a therapeutic stimulation phase with pain reduction was carried out.ResultsWith high pain levels SCS activated the cingulate gyrus, thalamus, prefrontal cortex, supplementary motor area and postcentral gyrus. After pain reduction, SCS did not elicit these activations in the second fMRI, using the same stimulation parameters.ConclusionsIn patients with chronic neuropathic pain and high VAS levels, SCS elicited BOLD activation in the cingulate gyrus, thalamus, prefrontal cortex, and primary and secondary somatosensory area. Pain reduction by SCS resulted in a reduction of functional activity in these areas as revealed by follow-up fMRI.

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