• Sei Fukui, Shino Shigemori, Atsushi Yoshimura, and Shuichi Nosaka.
• Department of Anesthesiology, Shiga University of Medical Science, Tukinowa, Seta, Otsu, Shiga 520-2192, Japan. sei@belle.shiga-med.ac.jp
• Reg Anesth Pain Med. 2002 Mar 1; 27 (2): 211-3.

BackgroundRecent neuroimaging studies suggested that chronic neuropathic pain may be largely sustained by a complex neuronal network involving the thalamus. Although recent studies have demonstrated the efficacy of electroconvulsive therapy (ECT) in the treatment of a variety of types of chronic neuropathic pain, the effects of ECT on regional cerebral blood flow (rCBF) have not been studied.Objectives And MethodsWe present a 50-year-old female postsurgical chronic pain patient whose pain had failed to respond to standard pain treatment, but was resolved by ECT. To investigate the potential role of rCBF in ECT's analgesic effect, we measured significant changes in the rCBF in the thalamus before and after a course of bilateral ECT using technetium-99m ethyl cysteinate dimer (99mTc-ECD) single photon emission computed tomography (SPECT).Results99mTc-ECD SPECT showed a significant bilateral decrease in the thalamus on the side of the pain, and this decreased rCBF in the thalamus increased after ECT.ConclusionsThe results from the SPECT suggest that ECT increases abnormally decreased thalamus activity in chronic neuropathic pain.

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