Management of chronic severe pain

Cerebral neuromodulatory and neuroablative approaches

Research output: Contribution to journalArticle

Abstract

Two approaches are utilized when targeting the brain to treat pain. The first, a non-destructive approach, uses either electrical stimulation of brain targets thought to modulate the process of pain perception, or pharmacological agents are introduced into ventricular spaces to target pain modulating receptors. Electrical stimulation targets include; the thalamic nuclei, the periventricular and periaqueductal grey (PVG and PAG) matter or the motor cortex. Currently, the pharmacological agent of choice for intracerebroventricular injection is morphine. In general, electrical stimulation is used for nonmalignant type pain, and pharmacological modulation for malignant type pain. The second, a destructive approach, is usually employed with the goal of interrupting the signals that lead to pain perception at various levels. Neuroablation is usually performed on cellular complexes such as "nuclei, or gyri" or on tracts with the aim of disrupting the sensory and limbic pathways involved in the emotional processes associated with pain. Specific cerebral neuroablation targets include; the thalamic medial group of nuclei, the cingulated gyrus, and the trigeminal nucleus and tract. There are fewer reports in the literature detailing the brain, when compared to the spine, as a target to treat pain, and further research is required.

Original languageEnglish (US)
Pages (from-to)17-26
Number of pages10
JournalActa Neurochirurgica, Supplementum
Issue number97 PART 2
DOIs
StatePublished - 2007

Fingerprint

Chronic Pain
Pain
Pain Perception
Pharmacology
Electric Stimulation
Trigeminal Nuclei
Mediodorsal Thalamic Nucleus
Thalamic Nuclei
Periaqueductal Gray
Nociceptors
Deep Brain Stimulation
Motor Cortex
Brain
Morphine
Spine
Injections
Research

Keywords

  • central pain
  • cerebral chronic pain
  • neuroablation
  • Neuromodulation
  • neuropathic pain
  • neurostimulation
  • review

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Medicine(all)

Cite this

@article{7dab3cbb00f54c4387b87fc999b7ad6d,
title = "Management of chronic severe pain: Cerebral neuromodulatory and neuroablative approaches",
abstract = "Two approaches are utilized when targeting the brain to treat pain. The first, a non-destructive approach, uses either electrical stimulation of brain targets thought to modulate the process of pain perception, or pharmacological agents are introduced into ventricular spaces to target pain modulating receptors. Electrical stimulation targets include; the thalamic nuclei, the periventricular and periaqueductal grey (PVG and PAG) matter or the motor cortex. Currently, the pharmacological agent of choice for intracerebroventricular injection is morphine. In general, electrical stimulation is used for nonmalignant type pain, and pharmacological modulation for malignant type pain. The second, a destructive approach, is usually employed with the goal of interrupting the signals that lead to pain perception at various levels. Neuroablation is usually performed on cellular complexes such as {"}nuclei, or gyri{"} or on tracts with the aim of disrupting the sensory and limbic pathways involved in the emotional processes associated with pain. Specific cerebral neuroablation targets include; the thalamic medial group of nuclei, the cingulated gyrus, and the trigeminal nucleus and tract. There are fewer reports in the literature detailing the brain, when compared to the spine, as a target to treat pain, and further research is required.",
keywords = "central pain, cerebral chronic pain, neuroablation, Neuromodulation, neuropathic pain, neurostimulation, review",
author = "Ahmed Raslan and Shirley McCartney and Kim Burchiel",
year = "2007",
doi = "10.1007/978-3-211-33081-4-2",
language = "English (US)",
pages = "17--26",
journal = "Acta neurochirurgica. Supplement",
issn = "0065-1419",
publisher = "Springer Wien",
number = "97 PART 2",

}

TY - JOUR

T1 - Management of chronic severe pain

T2 - Cerebral neuromodulatory and neuroablative approaches

AU - Raslan, Ahmed

AU - McCartney, Shirley

AU - Burchiel, Kim

PY - 2007

Y1 - 2007

N2 - Two approaches are utilized when targeting the brain to treat pain. The first, a non-destructive approach, uses either electrical stimulation of brain targets thought to modulate the process of pain perception, or pharmacological agents are introduced into ventricular spaces to target pain modulating receptors. Electrical stimulation targets include; the thalamic nuclei, the periventricular and periaqueductal grey (PVG and PAG) matter or the motor cortex. Currently, the pharmacological agent of choice for intracerebroventricular injection is morphine. In general, electrical stimulation is used for nonmalignant type pain, and pharmacological modulation for malignant type pain. The second, a destructive approach, is usually employed with the goal of interrupting the signals that lead to pain perception at various levels. Neuroablation is usually performed on cellular complexes such as "nuclei, or gyri" or on tracts with the aim of disrupting the sensory and limbic pathways involved in the emotional processes associated with pain. Specific cerebral neuroablation targets include; the thalamic medial group of nuclei, the cingulated gyrus, and the trigeminal nucleus and tract. There are fewer reports in the literature detailing the brain, when compared to the spine, as a target to treat pain, and further research is required.

AB - Two approaches are utilized when targeting the brain to treat pain. The first, a non-destructive approach, uses either electrical stimulation of brain targets thought to modulate the process of pain perception, or pharmacological agents are introduced into ventricular spaces to target pain modulating receptors. Electrical stimulation targets include; the thalamic nuclei, the periventricular and periaqueductal grey (PVG and PAG) matter or the motor cortex. Currently, the pharmacological agent of choice for intracerebroventricular injection is morphine. In general, electrical stimulation is used for nonmalignant type pain, and pharmacological modulation for malignant type pain. The second, a destructive approach, is usually employed with the goal of interrupting the signals that lead to pain perception at various levels. Neuroablation is usually performed on cellular complexes such as "nuclei, or gyri" or on tracts with the aim of disrupting the sensory and limbic pathways involved in the emotional processes associated with pain. Specific cerebral neuroablation targets include; the thalamic medial group of nuclei, the cingulated gyrus, and the trigeminal nucleus and tract. There are fewer reports in the literature detailing the brain, when compared to the spine, as a target to treat pain, and further research is required.

KW - central pain

KW - cerebral chronic pain

KW - neuroablation

KW - Neuromodulation

KW - neuropathic pain

KW - neurostimulation

KW - review

UR - http://www.scopus.com/inward/record.url?scp=34648843231&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34648843231&partnerID=8YFLogxK

U2 - 10.1007/978-3-211-33081-4-2

DO - 10.1007/978-3-211-33081-4-2

M3 - Article

SP - 17

EP - 26

JO - Acta neurochirurgica. Supplement

JF - Acta neurochirurgica. Supplement

SN - 0065-1419

IS - 97 PART 2

ER -