Artikel
The new concept of motor cortex stimulation in patients with central pain
Neus Konzept der Motor-cortex-Stimulation bei Patienten mit zentralem Schmerzsyndrom
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Autoren
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M. Kolodziej
- Neurochirurgische Klinik, Philipps-Universität Marburg
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D. Rasche
- Neurochirurgische Klinik, Universitätsklinikum Schleswig-Holstein, Lübeck
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V. Tronnier
- Neurochirurgische Klinik, Universitätsklinikum Schleswig-Holstein, Lübeck
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H. Bertalanffy
- Neurochirurgische Klinik, Philipps-Universität Marburg
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D. Hellwig
- Neurochirurgische Klinik, Philipps-Universität Marburg
| Veröffentlicht: | 8. Mai 2006 |
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Gliederung
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Objective: The previous (rod-)leads success-rate of the motor cortex stimulation in patients with central pain was 60% after surgery. This unsatisfactory results led to the development of a new lead and as a result of this development to the new study.
The aim of the new prospective, randomised, double-blind, multicenter, crossover study is to evaluate the safety and efficacy of motor cortex stimulation with the new cortical stimulation lead (circular, 8 electrodes) in patients with central pain. The results of the new study will be compared to the study-results of the rod-lead.
Methods: We include patients with neuropathic pain refractory to medical treatment. In the majority of the patients, pain duration longer than one year and stable pain medication longer than one month prior to enrolment are the main criteria for including the patients in the new study. After a craniotomy the implant procedure of a new lead begins. The target localisation of a lead is the central fissure, which is visualised through MRI or CT-scan. The lead is sutured to the dura to ensure a close contact with the dura. SSEPs and MEPs are used to confirm the localisation of the central sulcus. To evaluate the pain change and efficacy of the lead after surgery, the patient cam to the 12-month follow-up visit.
Conclusions: This prospective study supports the new development in the neuropathic pain-treatment. The new lead should reach the area of the central pain better and improve the benefit of the surgery. In contrast to the rod-lead, the new, circular lead has several stimulation possibilities.
