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the efficacy of motor cortex stimulation for pain control
Posted: Tue Feb 24, 2009 3:26 pm
by bermitt
what's everyone's opinion, i was asked to try a clinical trial. i said yes
Re: the efficacy of motor cortex stimulation for pain control
Posted: Wed Feb 25, 2009 4:11 pm
by srhykerd
What all does the study involve?
Re: the efficacy of motor cortex stimulation for pain control
Posted: Thu Feb 26, 2009 2:52 am
by Christopher
I posted a Clinical Trials participant recruiting for this a while back...
http://ubpn.org/messageboard/thread ... 392#156392
http://clinicaltrials.gov/ct/show/NCT00462566?order=3
I wrote to Robert M Brownstone, MD, PhD 902 473 6850
rob.brownstone@dal.ca 2 years ago asking him what his thoughts were on Spinal Cord Stimulators and Brachial Plexus Injuries, and he said in his opinion they are not worth it, and he forwarded me a study done on pain efficacy with SCS and it was too good... his study is different. I don't know much about it. I wish I could find that email, my computers are both fried right now, so everything is a mess. If I dig it out, I'll post it here.
Let us know what your decision is and what happens. It would help out a lot to have some first hand feedback and reports. Best of Luck!
Christopher
Re: the efficacy of motor cortex stimulation for pain control
Posted: Thu Feb 26, 2009 4:59 pm
by srhykerd
It seems to me that if this trial involves a spinal cord stimulator implant for pain control, and if your nerves are avulsed from the spinal cord, that the stimulator would not be effective. The stimulation could not get from the nerves to the CNS to achieve pain relief. I'm not sure all that the trial involves.
Re: the efficacy of motor cortex stimulation for pain control
Posted: Thu Feb 26, 2009 11:53 pm
by Christopher
> It seems to me that if this trial involves a spinal
> cord stimulator implant for pain control, and if your
> nerves are avulsed from the spinal cord, that the
> stimulator would not be effective. The stimulation
> could not get from the nerves to the CNS to achieve
> pain relief. I'm not sure all that the trial
> involves.
This is a Motor Cortex implant... straight to the brain.
Some people have had success with Spinal Cord Stimulators even though they had all 5 BP nerves avulsed.
Re: the efficacy of motor cortex stimulation for pain control
Posted: Fri Feb 27, 2009 12:19 am
by stx431
Hi, Carrie just recently had her spinal cord stimulator removed. After 8 years and countless adjustments it never worked to relieve any pain. She has the classic C5-T1 avulsions.
Dick
Re: the efficacy of motor cortex stimulation for pain control
Posted: Wed Mar 04, 2009 8:52 pm
by Christopher
This just came up on the radar...
http://www.modernmedicine.com/modernmed ... ryId=40127
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Motor Cortex Stimulation Has Good Results in Chronic Pain
It is safe and effective for treatment of chronic neuropathic pain
Feb 13, 2009
FRIDAY, Feb. 13 (HealthDay News) -- Motor cortex stimulation may lead to a significant improvement in symptoms for patients who experience severe chronic neuropathic pain resistant to medical treatment, according to research published in the February issue of the Journal of Neurosurgery.
Denys Fontaine, M.D., Ph.D., of the Universitaire de Nice-Sophia Antipolis in France, and colleagues performed a systematic review of the available published literature on the use of motor cortex stimulation for chronic neuropathic pain. The efficacy of the procedure, as well as related adverse effects, was evaluated. A total of 14 studies containing 210 patients were reviewed.
Approximately half (55 percent) of the patients who underwent surgery experienced a good response to motor cortex stimulation, defined as pain relief of at least 40 to 50 percent, the researchers report. A total of 152 patients underwent a postoperative follow-up at least one year later; of these patients 45 percent experienced a good response to motor cortex stimulation, the report indicates. Patients with central pain and trigeminal neuropathic pain both experienced a good response (54 percent and 68 percent, respectively). Complications included infections and hardware-related problems, the authors note.
"Considering the encouraging results of previous series on one hand, and the invasiveness and cost of the procedure on the other, a double-blinded, placebo-controlled randomized study is now mandatory to evaluate the actual efficacy of motor cortex stimulation," Fontaine and colleagues conclude.
The published Journal of Neurosurgery Abstract
http://thejns.org/doi/abs/10.3171/2008. ... alCode=jns