Open AccessAnalgesia in conjunction with normalisation of thermal sensation following deep brain stimulation for central post-stroke pain
Author(s) -
Anthony E. Pickering,
Simon R Thornton,
Sarah LoveJones,
Charlotte E. Steeds,
Nikunj K. Patel
Publication year - 2009
Publication title -
pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.524
H-Index - 258
eISSN - 1872-6623
pISSN - 0304-3959
DOI - 10.1016/j.pain.2009.09.011
Subject(s) - somatosensory system , medicine , sensation , hypoalgesia , central pain , anesthesia , deep brain stimulation , sensory system , analgesic , allodynia , stimulation , stroke (engine) , neuroscience , physical medicine and rehabilitation , psychology , hyperalgesia , nociception , mechanical engineering , receptor , disease , parkinson's disease , engineering
The aetiology of central post-stroke pain (CPSP) is poorly understood and such pains are often refractory to treatment. We report the case of a 56-year-old man, who, following a temporo-parietal infarct, suffered from debilitating and refractory hemi-body cold dysaesthesia and severe tactile allodynia. This was associated with thermal and tactile hypoaesthesia and hypoalgesia on his affected side. Implantation of a deep brain stimulating electrode in his periventricular gray (PVG) region produced an improvement in his pain that was associated with a striking normalisation of his deficits in somatosensory perception. This improvement in pain and thermal sensibility was reversed as stimulation became less effective, because of increased electrode impedance. Therefore, we postulate that the analgesic benefit may have occurred as a consequence of the normalisation of somatosensory function and we discuss these findings in relation to the theories of central pain generation and the potential to engage useful plasticity in central circuits.