Pain reduction by electrical brain stimulation in man

Part 1: Acute administration in periaqueductal and periventricular sites

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✓ Acute studies performed in five patients indicate that electrical stimulation of the brain could be a powerful tool for the reduction or control of intractable pain. While chronic or spontaneous pain could be relieved by stimulation of the periaqueductal gray matter, the accompanying side effects render it impossible to stimulate this site regularly. On the other hand, stimulation of medial thalamic sites, particularly medial to the nucleus parafascicularis, yielded good relief of chronic pain at parameters which did not cause many undesirable side effects. The same parameters also produced inhibition of acute pain in two of the five patients.

Article Information

Dr. Akil is currently supported by National Institutes of Health Fellowship NS 02337 and Alfred P. Sloan Research Fellowship in Neurophysiology BR-1609.

Address for Dr. Richardson: Suite 300, 2714 Canal Street, New Orleans, Louisiana 70119.

Address reprint requests to: Huda Akil, Ph.D., Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, California 94305.

© AANS, except where prohibited by US copyright law.

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Figures

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    Sites of stimulation in the five patients projected on the Schaltenbrand and Bailey Atlas. AQ = aqueduct of Sylvius; COI = inferior colliculi; COS = superior colliculi; HPTH = hypothalamus; RU = red nucleus; TH = thalamus.

References

1.

Akil HLiebeskind JC: Monoaminergic mechanisms of stimulation-produced analgesia. Brain Res 94:2792961975Akil H Liebeskind JC: Monoaminergic mechanisms of stimulation-produced analgesia. Brain Res 94:279–296 1975

2.

Akil HMayer DJ: Antagonism of stimulation-produced analgesia by p-CPA, a serotonin synthesis inhibitor. Brain Res 44:6926971972Akil H Mayer DJ: Antagonism of stimulation-produced analgesia by p-CPA a serotonin synthesis inhibitor. Brain Res 44:692–697 1972

3.

Ervin FRMark VHStevens J: Behavioral and affective responses to stimulation in man. Proc Am Psychopathol Assoc 58:54641968Ervin FR Mark VH Stevens J: Behavioral and affective responses to stimulation in man. Proc Am Psychopathol Assoc 58:54–64 1968

4.

Gol A: Relief of pain by electrical stimulation of the septal area. J Neurol Sci 5:1151201967Gol A: Relief of pain by electrical stimulation of the septal area. J Neurol Sci 5:115–120 1967

5.

Heath RGMickle WA: Evaluation of seven years' experience with depth electrode studies in human patients in Ramey ERO'Doherty DS (eds): Electrical Studies on the Unanesthesized Brain. New York: PB Hoeber1960 pp 214247Heath RG Mickle WA: Evaluation of seven years' experience with depth electrode studies in human patients in Ramey ER O'Doherty DS (eds): Electrical Studies on the Unanesthesized Brain. New York: PB Hoeber 1960 pp 214–247

6.

Liebeskind JCGuilbaud GBesson JHet al: Analgesia from electrical stimulation of the periaqueductal gray matter in the cat: behavioral observations and inhibitory effects on spinal cord interneurons. Brain Res 50:4414461973Liebeskind JC Guilbaud G Besson JH et al: Analgesia from electrical stimulation of the periaqueductal gray matter in the cat: behavioral observations and inhibitory effects on spinal cord interneurons. Brain Res 50:441–446 1973

7.

Liebman JMMayer DJLiebeskind JC: Mesencephalic central gray lesions and fearmotivated behavior in rats. Brain Res 23:3533701970Liebman JM Mayer DJ Liebeskind JC: Mesencephalic central gray lesions and fearmotivated behavior in rats. Brain Res 23:353–370 1970

8.

Long D: Medtronics Symposium on Spinal Cord Stimulation. Minneapolis, MinnesotaSeptember, 1972Long D: Medtronics Symposium on Spinal Cord Stimulation. Minneapolis Minnesota September 1972

9.

Mayer DJLiebeskind JC: Pain reduction by focal electrical stimulation of the brain: an anatomical and behavior analysis. Brain Res 68:73931974Mayer DJ Liebeskind JC: Pain reduction by focal electrical stimulation of the brain: an anatomical and behavior analysis. Brain Res 68:73–93 1974

10.

Mayer DJWolfle TLAkil Het al: Analgesia from electrical stimulation in the brain stem of the rat. Science 174:135113541971Mayer DJ Wolfle TL Akil H et al: Analgesia from electrical stimulation in the brain stem of the rat. Science 174:1351–1354 1971

11.

Nashold BS JrWilson WPSlaughter DG: Sensations evoked by stimulation in the midbrain of man. J Neurosurg 30:14241969Nashold BS Jr Wilson WP Slaughter DG: Sensations evoked by stimulation in the midbrain of man. J Neurosurg 30:14–24 1969

12.

Reynolds DV: Surgery in the rat during electrical analgesia induced by focal brain stimulation. Science 164:4444451969Reynolds DV: Surgery in the rat during electrical analgesia induced by focal brain stimulation. Science 164:444–445 1969

13.

Richardson DE: Thalamotomy for intractable pain. Confin Neurol 29:1391451967Richardson DE: Thalamotomy for intractable pain. Confin Neurol 29:139–145 1967

14.

Richardson DEAkil H: Pain reduction by electrical brain stimulation in man. Part 2: Chronic self-administration in the periventricular gray matter. J Neurosurg 47:1841941977Richardson DE Akil H: Pain reduction by electrical brain stimulation in man. Part 2: Chronic self-administration in the periventricular gray matter. J Neurosurg 47:184–194 1977

15.

Schaltenbrand GBailey P: Introduction to Stereotaxis with an Atlas of the Human BrainVolume 2. New York: Grune and Stratton(Stuttgart: Georg Thieme Verlag)1959Schaltenbrand G Bailey P: Introduction to Stereotaxis with an Atlas of the Human Brain Volume 2. New York: Grune and Stratton (Stuttgart: Georg Thieme Verlag) 1959

16.

Shealy CNMortimer JTReswick JB: Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report. Anesth Analg 46:4894911967Shealy CN Mortimer JT Reswick JB: Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report. Anesth Analg 46:489–491 1967

17.

Sweet WHWepsic JG: Stimulation of peripheral pain suppressor mechanisms: a critique of some current methods in Bonica JJ (ed): Advances in Neurology Volume 4: International Symposium on Pain. New York: Raven Press1974 pp 737748Sweet WH Wepsic JG: Stimulation of peripheral pain suppressor mechanisms: a critique of some current methods in Bonica JJ (ed): Advances in Neurology Volume 4: International Symposium on Pain. New York: Raven Press 1974 pp 737–748

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