Nuti C et al. (2005) Motor cortex stimulation for refractory neuropathic pain: four year outcome and predictors of efficacy. Pain 118: 43–52
There is some evidence that stimulation of the primary motor cortex can bring relief to patients with medically refractive neuropathic pain. Nuti and colleagues have carried out a prospective study to examine the long-term efficacy of this technique.
A total of 31 consecutive patients with neuropathic pain were recruited. Pain was a consequence of hemorrhagic or ischemic stroke in most cases, and all patients had failed to respond to conventional therapies. Each patient had a motor cortex stimulation device implanted under general anesthesia, with one or two electrodes positioned over the motor region corresponding to the pain.
During a mean postoperative follow-up period of 4 years, 3 patients (10%) experienced 'excellent' pain relief, whereas 13 (42%) reported that the results were 'good'. Pain relief was 'poor' or 'negligible' in the remaining 15 cases (48%). Approximately half of the patients decreased their use of analgesics after the surgery, and these drugs were stopped altogether in 11 cases (35%). Long-term pain relief was predicted by the degree of pain relief recorded in the first month after surgery.
These findings indicate that motor cortex stimulation can offer long-lasting relief of neuropathic pain in some patients. The authors state that further work in this area should include larger numbers of patients and should focus on improving patient selection.
Rights and permissions
About this article
Cite this article
Kirby, R. Motor cortex stimulation in the treatment of neuropathic pain. Nat Rev Neurol 2, 5 (2006). https://doi.org/10.1038/ncpneuro0061
Issue Date:
DOI: https://doi.org/10.1038/ncpneuro0061