Motor cortex stimulation therapy for the treatment of post-stroke pain: operation method and pain alleviation mechanism
| Project/Area Number |
15591553
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | Nihon University |
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Principal Investigator |
YAMAMOTO Takamitsu Nihon University, School of Medicine, Professor, 医学部, 教授 (50158284)
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| Co-Investigator(Kenkyū-buntansha) |
KATAYAMA Yoichi Nihon University, School of Medicine, Professor, 医学部, 教授 (00125048)
FUKAYA Chikashi Nihon University, School of Medicine, Associate Prof., 医学部, 講師 (50287637)
OSHIMA Hideki Nihon University, School of Medicine, Instructor, 医学部, 助手 (20328735)
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| Project Period (FY) |
2003 – 2005
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| Project Status |
Completed (Fiscal Year 2005)
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| Budget Amount *help |
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2005: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 2004: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2003: ¥2,400,000 (Direct Cost: ¥2,400,000)
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| Keywords | post-stroke pain / central pain / motor cortex / motor evoke potential / corticospinal tract / D-wave / I-wave / 大脳皮質運動領 / 痛み / 運動誘発電位 / 視床痛 / 中枢性疼痛 / ketamine / drug challenge test / pain / motor evoked potential |
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| Research Abstract |
The corticospinal motor evoked potential (MEP) evoked by motor cortex stimulation can be recorded from the epidural space of the spinal cord. The corticospinal MEP response consists of an initial D-wave and a later sequence of volleys termed I-waves. The D-wave, which reflects impulses arising from direct activation of the axons of corticospinal tract neurons and is resistant to anesthetics, was investigated as an intra-operative index for the placement of a stimulating electrode in the epidural space over the motor cortex for the treatment of post-stroke pain.
A grid electrode comprising 20 plate electrodes of 5mm in diameter and each separated by 5mm, was placed in the epidural space aiming to cover the motor cortex, sensory cortex, and premotor cortex employing an MRI-guided neuronavigation system in post-stroke pain patients. Initially, the D-wave was recorded with anodal monopolar stimulation of each plate electrode under general anesthesia. Secondly, keeping the grid electrode at the same position, the effect of pain reduction induced by anodal monopolar stimulation of the same epidural plate electrodes was examined using a visual analogue scale (VAS) on a separate day in the awake state without anesthesia.
A comparison between the reduction rate of the VAS and the recorded amplitude of the D-wave employing the same stimulation point of the grid electrode revealed a significant correlation. The results obtained indicated the importance of D-wave recording as an intra-operative index for placement of the stimulating electrode over the motor cortex, and we can expect an improvement of the clinical results achieved with motor cortex stimulation.
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Report
(4 results)
Research Products
(31 results)
