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Neuroradiology. 2013 Aug;55(8):1039-1047. doi: 10.1007/s00234-013-1200-7. Epub 2013 May 12.

Spinal cord stimulation modulates cerebral neurobiology: a proton magnetic resonance spectroscopy study.

Author information

1
Department of Neurosurgery and Center for Neuroscience, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium. mtmoens@gmail.com.
2
Department of Neurology, ZNA Middelheim General Hospital, Lindendreef 1, 2020, Antwerp, Belgium.
3
Department of Clinical and Experimental Neurolinguistics, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
4
Neurology and Center for Neuroscience, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
5
Anesthesiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
6
Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
7
Cardiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
8
Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
9
Department of Radiology, UZ Leuven, Katholieke Universiteit Leuven, Herestraat 49, 3000, Leuven, Belgium.
10
Neurosurgery, UZ Leuven, Katholieke Universiteit Leuven, Herestraat 49, 3000, Leuven, Belgium.

Abstract

INTRODUCTION:

Although spinal cord stimulation (SCS) is a widely used treatment for chronic neuropathic pain secondary to spinal surgery, little is known about the underlying physiological mechanisms.

METHODS:

The primary aim of this study is to investigate the neural substrate underlying short-term SCS by means of (1)H MR spectroscopy with short echo time, in 20 patients with failed back surgery syndrome.

RESULTS:

Marked increase of γ-aminobutyric acid (GABA) and decrease in glucose in the ipsilateral thalamus were found between baseline situation without SCS and after 9' of SCS, indicating the key role of the ipsilateral thalamus as a mediator of chronic neuropathic pain. In addition, this study also showed a progressive decrease in glucose in the ipsilateral thalamus over time, which is in line with the findings of previous studies reporting deactivation in the ipsilateral thalamic region.

CONCLUSIONS:

The observation of GABA increase and glucose decrease over time in the ipsilateral thalamus may be the causal mechanism of the pain relief due to SCS or an epiphenomenon.

PMID:
23665999
DOI:
10.1007/s00234-013-1200-7
[Indexed for MEDLINE]

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