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Journal ArticleDOI

Subcortical electrical stimulation for control of intractable pain in humans: Report of 122 cases (1970–1984)

Yoshio Hosobuchi
- 01 Apr 1986 - 
- Vol. 64, Iss: 4, pp 543-553
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TLDR
The electrical stimulation technique appears to provide long-term pain control safely, with few side effects or complications.
Abstract
Chronic electrical stimulation of the subcortical area of the brain by implanted electrodes provides satisfactory control of a number of intractable pain syndromes that are refractory to medication. This series of 122 patients who underwent electrode implantation for the control of severe chronic pain was evaluated over a follow-up period of 2 to 14 years. Of the 65 patients with pain of peripheral origin, who were treated with stimulation of the periaqueductal gray region (PAG), 50 obtained successful pain control. Of 76 patients with a deafferentation pain syndrome, 44 obtained control of the dysesthesia with stimulation of the subcortical somatosensory region. Nineteen patients with both leg and back pain received electrodes in the PAG and the somatosensory regions; whereas back pain was relieved by PAG stimulation, dysesthetic leg pain was controlled more effectively by somatosensory region stimulation. The electrical stimulation technique appears to provide long-term pain control safely, with few side effects or complications.

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Citations
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Journal ArticleDOI

Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders

TL;DR: Chronic VIM stimulation, which is reversible, adaptable, and well tolerated even by patients undergoing bilateral surgery and by elderly patients, should replace thalamotomy in the regular surgical treatment of parkinsonian and essential tremors.
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Functional characteristics of the midbrain periaqueductal gray

TL;DR: The major functions of the midbrain periaqueductal gray, including pain and analgesia, fear and anxiety, vocalization, lordosis and cardiovascular control are considered and a model is proposed to account for the interactions between these different functional components.
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The nature of opioid responsiveness and its implications for neuropathic pain: new hypotheses derived from studies of opioid infusions.

TL;DR: This analysis hypothesizes that opioid responsiveness in man can be defined by the degree of analgesia achieved during dose escalation to either intolerable side effects or the occurrence of ‘complete’ or ‘adequate’ analgesia, and proposes a clinically relevant definition and a paradigm for its investigation.
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Cortical and subcortical localization of response to pain in man using positron emission tomography.

TL;DR: A quantitative study of the regional cerebral responses to non-painful and painful thermal stimuli in six normal volunteers by monitoring serial measurements of regional blood flow measured by positron emission tomography found highly significant increases in blood flow in response to painful heat.
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Chronic motor cortex stimulation in patients with thalamic pain

TL;DR: While stimulation of the first- to third-order sensory neurons at the level of the thalamic relay nucleus or below cannot bring about good pain inhibition in patients withThalamic pain, activation of hypothetical fourth- order sensory neurons through precentral stimulation may be able to inhibit deafferented nociceptive neurons within the cortex.
References
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Journal ArticleDOI

Surgery in the Rat during Electrical Analgesia Induced by Focal Brain Stimulation

TL;DR: It was concluded that focal brain stimulation in this region can induce analgesia in the absence of diffusely applied "whole brain" stimulation.
Journal ArticleDOI

Endogenous pain control mechanisms: review and hypothesis.

TL;DR: Evidence is presented that the intrinsic neural network that monitors and modulates the activity of pain‐transmitting neurons is mediated in part by endogenous opiatelike compounds (endorphins).
Journal ArticleDOI

Analgesia from Electrical Stimulation in the Brainstem of the Rat

TL;DR: Stimulation at several mesencephalic and diencephalic sites abolished responsiveness to intense pain in rats while leaving responsiveness to other sensory modes relatively unaffected.
Journal ArticleDOI

Pain relief by electrical stimulation of the central gray matter in humans and its reversal by naloxone.

TL;DR: The results suggest that satisfactory alleviation of persistent pain in humans may be obtained by electronic stimulation.
Journal ArticleDOI

Central nervous system mechanisms of analgesia.

TL;DR: The intent of this review is to examine and synthesize the extensive progress that has been made in the last few years describing the anatomical, physiological and neurohumoral substrates of neural systems which modulate pain perception.
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