Chronic pain: a PET study of the central effects of percutaneous high cervical cordotomy.

Détails

ID Serval
serval:BIB_82686FDAB01E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Chronic pain: a PET study of the central effects of percutaneous high cervical cordotomy.
Périodique
Pain
Auteur(s)
Di Piero V., Jones A.K., Iannotti F., Powell M., Perani D., Lenzi G.L., Frackowiak R.S.
ISSN
0304-3959 (Print)
ISSN-L
0304-3959
Statut éditorial
Publié
Date de publication
1991
Volume
46
Numéro
1
Pages
9-12
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
We have studied 5 patients with unilateral, severe chronic pain due to cancer before and after percutaneous, ventrolateral cervical cordotomy to investigate the central effects of the procedure. The aim was to identify the functional anatomical correlates of abolishing unilateral nociceptive input to the brain. Patients were investigated by positron emission tomography using C15O2 to evaluate cerebral blood flow. Comparisons were made between the patients with unilateral pain before cordotomy and normal volunteers. These demonstrated significantly less blood flow in 3 out of 4 of the individual quadrants of the hemithalamus contralateral to the side of pain (P less than 0.01-0.05). These differences were abolished by cordotomy. Comparison of the patients before and after cordotomy showed a significant decrease in blood flow in the dorsal anterior quadrant of the thalamus contralateral to the side of pain (P less than 0.05) which was normalised after cordotomy. There were no significant changes in the prefrontal or primary somatosensory cortex. We conclude that chronic pain results in a decrease of synaptic activity at thalamic level either from decreased activity in neurones projecting to that region and/or attenuated local neuronal firing. We have demonstrated no secondary remote effects in cortex, indicating the importance of subcortical mechanisms in central responses to chronic pain.
Mots-clé
Aged, Cerebrovascular Circulation/physiology, Cervical Vertebrae, Cordotomy, Female, Humans, Male, Middle Aged, Neoplasms/physiopathology, Pain, Intractable/physiopathology, Pain, Intractable/radionuclide imaging, Palliative Care, Spinal Cord/physiopathology, Spinal Cord/radionuclide imaging, Thalamus/physiopathology, Thalamus/radionuclide imaging, Tomography, Emission-Computed
Pubmed
Web of science
Création de la notice
25/09/2011 16:59
Dernière modification de la notice
20/08/2019 14:42
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