The Experts below are selected from a list of 576 Experts worldwide ranked by ideXlab platform
Toshiki Yoshimine - One of the best experts on this subject based on the ideXlab platform.
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reduction of intractable Deafferentation Pain due to spinal cord or peripheral lesion by high frequency repetitive transcranial magnetic stimulation of the primary motor cortex
Journal of Neurosurgery, 2007Co-Authors: Youichi Saitoh, Haruhiko Kishima, Amami Kato, Masayuki Hirata, Azuma Hirayama, Satoru Oshino, Toshio Shimokawa, Naoki Tani, Toshiki YoshimineAbstract:Object The authors previously reported that navigation-guided repetitive transcranial magnetic stimulation (rTMS) of the precentral gyrus relieves Deafferentation Pain. Stimulation parameters were 10 trains of 10-second 5-Hz TMS pulses at 50-second intervals. In the present study, they used various stimulation frequencies and compared efficacies between two types of lesions. Methods Patients were divided into two groups: those with a cerebral lesion and those with a noncerebral lesion. The rTMS was applied to all the patients at frequencies of 1, 5, and 10 Hz and as a sham procedure in random order. The effect of rTMS on Pain was rated by patients using a visual analog scale. Results The rTMS at frequencies of 5 and 10 Hz, compared with sham stimulation, significantly reduced Pain, and the Pain reduction continued for 180 minutes. A stimulation frequency of 10 Hz may be more effective than 5 Hz, and at 1 Hz was ineffective. The effect of rTMS at frequencies of 5 and 10 Hz was greater in patients with a no...
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motor cortex stimulation in patients with Deafferentation Pain activation of the posterior insula and thalamus
Journal of Neurosurgery, 2007Co-Authors: Haruhiko Kishima, Youichi Saitoh, Yasuhiro Osaki, Hiroshi Nishimura, Amami Kato, Jun Hatazawa, Toshiki YoshimineAbstract:Object The mechanisms underlying Deafferentation Pain are not well understood. Motor cortex stimulation (MCS) is useful in the treatment of this kind of chronic Pain, but the detailed mechanisms underlying its effects are unknown. Methods Six patients with intractable Deafferentation Pain in the left hand were included in this study. All were right-handed and had a subdural electrode placed over the right precentral gyrus. The Pain was associated with brainstem injury in one patient, cervical spine injury in one patient, thalamic hemorrhage in one patient, and brachial plexus avulsion in three patients. Treatment with MCS reduced Pain; visual analog scale (VAS) values for Pain were 82 ± 20 before MCS and 39 ± 20 after MCS (mean ± standard error). Regional cerebral blood flow (rCBF) was measured by positron emission tomography with H215O before and after MCS. The obtained images were analyzed with statistical parametric mapping software (SPM99). Results Significant rCBF increases were identified after MCS ...
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:Abstract The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p<0.01). Results indicated a statistically significant effect lasting for 3 hours after the stimulation of M1 (p<0.05). Stimulation of other targets was not effective. The M1 was the sole target for treating intractable Pain with rTMS, in spite of the fact that M1, S1, preM, and SMA are located adjacently.
Youichi Saitoh - One of the best experts on this subject based on the ideXlab platform.
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reduction of intractable Deafferentation Pain due to spinal cord or peripheral lesion by high frequency repetitive transcranial magnetic stimulation of the primary motor cortex
Journal of Neurosurgery, 2007Co-Authors: Youichi Saitoh, Haruhiko Kishima, Amami Kato, Masayuki Hirata, Azuma Hirayama, Satoru Oshino, Toshio Shimokawa, Naoki Tani, Toshiki YoshimineAbstract:Object The authors previously reported that navigation-guided repetitive transcranial magnetic stimulation (rTMS) of the precentral gyrus relieves Deafferentation Pain. Stimulation parameters were 10 trains of 10-second 5-Hz TMS pulses at 50-second intervals. In the present study, they used various stimulation frequencies and compared efficacies between two types of lesions. Methods Patients were divided into two groups: those with a cerebral lesion and those with a noncerebral lesion. The rTMS was applied to all the patients at frequencies of 1, 5, and 10 Hz and as a sham procedure in random order. The effect of rTMS on Pain was rated by patients using a visual analog scale. Results The rTMS at frequencies of 5 and 10 Hz, compared with sham stimulation, significantly reduced Pain, and the Pain reduction continued for 180 minutes. A stimulation frequency of 10 Hz may be more effective than 5 Hz, and at 1 Hz was ineffective. The effect of rTMS at frequencies of 5 and 10 Hz was greater in patients with a no...
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motor cortex stimulation in patients with Deafferentation Pain activation of the posterior insula and thalamus
Journal of Neurosurgery, 2007Co-Authors: Haruhiko Kishima, Youichi Saitoh, Yasuhiro Osaki, Hiroshi Nishimura, Amami Kato, Jun Hatazawa, Toshiki YoshimineAbstract:Object The mechanisms underlying Deafferentation Pain are not well understood. Motor cortex stimulation (MCS) is useful in the treatment of this kind of chronic Pain, but the detailed mechanisms underlying its effects are unknown. Methods Six patients with intractable Deafferentation Pain in the left hand were included in this study. All were right-handed and had a subdural electrode placed over the right precentral gyrus. The Pain was associated with brainstem injury in one patient, cervical spine injury in one patient, thalamic hemorrhage in one patient, and brachial plexus avulsion in three patients. Treatment with MCS reduced Pain; visual analog scale (VAS) values for Pain were 82 ± 20 before MCS and 39 ± 20 after MCS (mean ± standard error). Regional cerebral blood flow (rCBF) was measured by positron emission tomography with H215O before and after MCS. The obtained images were analyzed with statistical parametric mapping software (SPM99). Results Significant rCBF increases were identified after MCS ...
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:Abstract The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p<0.01). Results indicated a statistically significant effect lasting for 3 hours after the stimulation of M1 (p<0.05). Stimulation of other targets was not effective. The M1 was the sole target for treating intractable Pain with rTMS, in spite of the fact that M1, S1, preM, and SMA are located adjacently.
Haruhiko Kishima - One of the best experts on this subject based on the ideXlab platform.
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reduction of intractable Deafferentation Pain due to spinal cord or peripheral lesion by high frequency repetitive transcranial magnetic stimulation of the primary motor cortex
Journal of Neurosurgery, 2007Co-Authors: Youichi Saitoh, Haruhiko Kishima, Amami Kato, Masayuki Hirata, Azuma Hirayama, Satoru Oshino, Toshio Shimokawa, Naoki Tani, Toshiki YoshimineAbstract:Object The authors previously reported that navigation-guided repetitive transcranial magnetic stimulation (rTMS) of the precentral gyrus relieves Deafferentation Pain. Stimulation parameters were 10 trains of 10-second 5-Hz TMS pulses at 50-second intervals. In the present study, they used various stimulation frequencies and compared efficacies between two types of lesions. Methods Patients were divided into two groups: those with a cerebral lesion and those with a noncerebral lesion. The rTMS was applied to all the patients at frequencies of 1, 5, and 10 Hz and as a sham procedure in random order. The effect of rTMS on Pain was rated by patients using a visual analog scale. Results The rTMS at frequencies of 5 and 10 Hz, compared with sham stimulation, significantly reduced Pain, and the Pain reduction continued for 180 minutes. A stimulation frequency of 10 Hz may be more effective than 5 Hz, and at 1 Hz was ineffective. The effect of rTMS at frequencies of 5 and 10 Hz was greater in patients with a no...
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motor cortex stimulation in patients with Deafferentation Pain activation of the posterior insula and thalamus
Journal of Neurosurgery, 2007Co-Authors: Haruhiko Kishima, Youichi Saitoh, Yasuhiro Osaki, Hiroshi Nishimura, Amami Kato, Jun Hatazawa, Toshiki YoshimineAbstract:Object The mechanisms underlying Deafferentation Pain are not well understood. Motor cortex stimulation (MCS) is useful in the treatment of this kind of chronic Pain, but the detailed mechanisms underlying its effects are unknown. Methods Six patients with intractable Deafferentation Pain in the left hand were included in this study. All were right-handed and had a subdural electrode placed over the right precentral gyrus. The Pain was associated with brainstem injury in one patient, cervical spine injury in one patient, thalamic hemorrhage in one patient, and brachial plexus avulsion in three patients. Treatment with MCS reduced Pain; visual analog scale (VAS) values for Pain were 82 ± 20 before MCS and 39 ± 20 after MCS (mean ± standard error). Regional cerebral blood flow (rCBF) was measured by positron emission tomography with H215O before and after MCS. The obtained images were analyzed with statistical parametric mapping software (SPM99). Results Significant rCBF increases were identified after MCS ...
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:Abstract The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p<0.01). Results indicated a statistically significant effect lasting for 3 hours after the stimulation of M1 (p<0.05). Stimulation of other targets was not effective. The M1 was the sole target for treating intractable Pain with rTMS, in spite of the fact that M1, S1, preM, and SMA are located adjacently.
Masayuki Hirata - One of the best experts on this subject based on the ideXlab platform.
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reduction of intractable Deafferentation Pain due to spinal cord or peripheral lesion by high frequency repetitive transcranial magnetic stimulation of the primary motor cortex
Journal of Neurosurgery, 2007Co-Authors: Youichi Saitoh, Haruhiko Kishima, Amami Kato, Masayuki Hirata, Azuma Hirayama, Satoru Oshino, Toshio Shimokawa, Naoki Tani, Toshiki YoshimineAbstract:Object The authors previously reported that navigation-guided repetitive transcranial magnetic stimulation (rTMS) of the precentral gyrus relieves Deafferentation Pain. Stimulation parameters were 10 trains of 10-second 5-Hz TMS pulses at 50-second intervals. In the present study, they used various stimulation frequencies and compared efficacies between two types of lesions. Methods Patients were divided into two groups: those with a cerebral lesion and those with a noncerebral lesion. The rTMS was applied to all the patients at frequencies of 1, 5, and 10 Hz and as a sham procedure in random order. The effect of rTMS on Pain was rated by patients using a visual analog scale. Results The rTMS at frequencies of 5 and 10 Hz, compared with sham stimulation, significantly reduced Pain, and the Pain reduction continued for 180 minutes. A stimulation frequency of 10 Hz may be more effective than 5 Hz, and at 1 Hz was ineffective. The effect of rTMS at frequencies of 5 and 10 Hz was greater in patients with a no...
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:Abstract The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p<0.01). Results indicated a statistically significant effect lasting for 3 hours after the stimulation of M1 (p<0.05). Stimulation of other targets was not effective. The M1 was the sole target for treating intractable Pain with rTMS, in spite of the fact that M1, S1, preM, and SMA are located adjacently.
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stimulation of primary motor cortex for intractable Deafferentation Pain
Acta Neurochirurgica, 2006Co-Authors: Azuma Hirayama, Satoru Oshino, Masayuki HirataAbstract:The stimulation of the primary motor cortex (M1) has proved to be an effective treatment for intractable Deafferentation Pain. This treatment started in 1990, and twenty-eight studies involving 271 patients have been reported so far. The patients who have been operated on were suffering from post-stroke Pain (59%), trigeminal neuropathic Pain, brachial plexus injury, spinal cord injury, peripheral nerve injury and phantom-limb Pain. The method of stimulation was: a) epidural, b) subdural, and c) within the central sulcus. Overall, considering the difficulty in treating central neuropathic Pain, trigeminal neuropathic Pain and certain types of refractory peripheral Pain, the electrical stimulation of M1 is a very promising technique; nearly 60% of the treated patients improved with a higher than 50% Pain relief after several months of follow-up and sometimes of a few years in most reports. The mechanism of Pain relief by the electrical stimulation of M1 has been under investigation. Recently, repetitive transcranial magnetic stimulation (rTMS) of M1 has been reported to be effective on Deafferentation Pain. In the future, rTMS may take over from electrical stimulation as a treatment for Deafferentation Pain.
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motor cortex stimulation for central and peripheral Deafferentation Pain report of eight cases
Journal of Neurosurgery, 2000Co-Authors: Masahiko Shibata, S Hirano, Masayuki Hirata, Takashi MashimoAbstract:The authors tested a modified motor cortex stimulation protocol for treatment of central and peripheral types of Deafferentation Pain. Four patients with thalamic Pain and four with peripheral Deafferentation Pain were studied. Preoperative pharmacological tests of Pain relief were performed using phentolamine, lidocaine, ketamine, thiopental, and placebo. In five patients we placed a 20- or 40-electrode grid in the subdural space to determine the best stimulation point for Pain relief for a few weeks before definitive placement of a four-electrode array. In three patients, the four-electrode array was implanted in the interhemispheric fissure as a one-stage procedure to treat lower-extremity Pain. In two patients with Pain extending from the extremity to the trunk or hip, dual devices were implanted to drive two electrodes. Six of eight patients experienced Pain reduction (two each with excellent, good, and fair relief) from motor cortex stimulation. No correlation was apparent between pharmacological test results and the effectiveness of motor cortex stimulation. Patients with peripheral Deafferentation Pain, including two with phantom-limb Pain and two with brachial plexus injury, attained Pain relief from motor cortex stimulation, with excellent results in two cases. Testing performed with a subdural multiple-electrode grid was helpful in locating the best stimulation point for Pain relief. Motor cortex stimulation may be effective for treating peripheral as well as central Deafferentation Pain.
Amami Kato - One of the best experts on this subject based on the ideXlab platform.
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reduction of intractable Deafferentation Pain due to spinal cord or peripheral lesion by high frequency repetitive transcranial magnetic stimulation of the primary motor cortex
Journal of Neurosurgery, 2007Co-Authors: Youichi Saitoh, Haruhiko Kishima, Amami Kato, Masayuki Hirata, Azuma Hirayama, Satoru Oshino, Toshio Shimokawa, Naoki Tani, Toshiki YoshimineAbstract:Object The authors previously reported that navigation-guided repetitive transcranial magnetic stimulation (rTMS) of the precentral gyrus relieves Deafferentation Pain. Stimulation parameters were 10 trains of 10-second 5-Hz TMS pulses at 50-second intervals. In the present study, they used various stimulation frequencies and compared efficacies between two types of lesions. Methods Patients were divided into two groups: those with a cerebral lesion and those with a noncerebral lesion. The rTMS was applied to all the patients at frequencies of 1, 5, and 10 Hz and as a sham procedure in random order. The effect of rTMS on Pain was rated by patients using a visual analog scale. Results The rTMS at frequencies of 5 and 10 Hz, compared with sham stimulation, significantly reduced Pain, and the Pain reduction continued for 180 minutes. A stimulation frequency of 10 Hz may be more effective than 5 Hz, and at 1 Hz was ineffective. The effect of rTMS at frequencies of 5 and 10 Hz was greater in patients with a no...
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motor cortex stimulation in patients with Deafferentation Pain activation of the posterior insula and thalamus
Journal of Neurosurgery, 2007Co-Authors: Haruhiko Kishima, Youichi Saitoh, Yasuhiro Osaki, Hiroshi Nishimura, Amami Kato, Jun Hatazawa, Toshiki YoshimineAbstract:Object The mechanisms underlying Deafferentation Pain are not well understood. Motor cortex stimulation (MCS) is useful in the treatment of this kind of chronic Pain, but the detailed mechanisms underlying its effects are unknown. Methods Six patients with intractable Deafferentation Pain in the left hand were included in this study. All were right-handed and had a subdural electrode placed over the right precentral gyrus. The Pain was associated with brainstem injury in one patient, cervical spine injury in one patient, thalamic hemorrhage in one patient, and brachial plexus avulsion in three patients. Treatment with MCS reduced Pain; visual analog scale (VAS) values for Pain were 82 ± 20 before MCS and 39 ± 20 after MCS (mean ± standard error). Regional cerebral blood flow (rCBF) was measured by positron emission tomography with H215O before and after MCS. The obtained images were analyzed with statistical parametric mapping software (SPM99). Results Significant rCBF increases were identified after MCS ...
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:Abstract The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p
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reduction of intractable Deafferentation Pain by navigation guided repetitive transcranial magnetic stimulation of the primary motor cortex
Pain, 2006Co-Authors: Azuma Hirayama, Haruhiko Kishima, Youichi Saitoh, Amami Kato, Masayuki Hirata, Satoru Oshino, Toshio Shimokawa, Toshiki YoshimineAbstract:The precentral gyrus (M1) is a representative target for electrical stimulation therapy of Pain. To date, few researchers have investigated whether Pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on Pain. Twenty patients with intractable Deafferentation Pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on Pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial Pain relief (p<0.01). Results indicated a statistically significant effect lasting for 3 hours after the stimulation of M1 (p<0.05). Stimulation of other targets was not effective. The M1 was the sole target for treating intractable Pain with rTMS, in spite of the fact that M1, S1, preM, and SMA are located adjacently.