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Somatotopy of the sensory thalamus: inputs from directional deep brain stimulation in pain patients.
Leplus, Aurelie; Isan, Petru; Balossier, Anne; Mouffok, Sarah; Donnet, Anne; Papadopoulo, Theodore; Lanteri-Minet, Michel; Regis, Jean; Fontaine, Denys.
Afiliación
  • Leplus A; Department of Neurosurgery, FHU INOVPAIN, CHU de Nice, Université Côte d'Azur, Nice, France.
  • Isan P; UR2CA, Université Côte d'Azur, Nice, France.
  • Balossier A; Department of Neurosurgery, FHU INOVPAIN, CHU de Nice, Université Côte d'Azur, Nice, France.
  • Mouffok S; UR2CA, Université Côte d'Azur, Nice, France.
  • Donnet A; Department of Neurosurgery, Hopital La Timone, APHM, FHU INOVPAIN, Marseille, France.
  • Papadopoulo T; INRIA Center, Université Cote d'Azur, Sophia Antipolis, France.
  • Lanteri-Minet M; Pain Clinic, Hopital La Timone, APHM, Marseille, France.
  • Regis J; Neuro-Dol, Trigeminal Pain, INSERM/UCA, U1107, Clermont-Ferrand, France.
  • Fontaine D; INRIA Center, Université Cote d'Azur, Sophia Antipolis, France.
Ann Clin Transl Neurol ; 11(6): 1502-1513, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38668642
ABSTRACT

OBJECTIVE:

The sensory ventroposterior (VP) thalamic nuclei display a mediolateral somatotopic organization (respectively head, arm, and leg). We studied this somatotopy using directional VP deep brain stimulation (DBS) in patients treated for chronic neuropathic pain.

METHODS:

Six patients with central (four) or peripheral (two) neuropathic pain were treated by VP DBS using directional leads in a prospective study (clinicaltrials.gov NCT03399942). Lead-DBS toolbox was used for leads localization, visualization, and modeling of the volume of tissue activated (VTA). Stimulation was delivered in each direction, 1 month after surgery and correlated to the location of stimulation-induced paresthesias. The somatotopy was modeled by correlating the respective locations of paresthesias and VTAs. We recorded 48 distinct paresthesia maps corresponding to 48 VTAs (including 36 related to directional stimulation).

RESULTS:

We observed that, in each patient, respective body representations of the trunk, upper limb, lower limb, and head were closely located around the lead. These representations differed across patients, did not follow a common organization and were not concordant with the previously described somatotopic organization of the sensory thalamus.

INTERPRETATION:

Thalamic reorganization has been reported in chronic pain patients compared to non-pain patients operated for movement disorders in previous studies using intraoperative recordings and micro-stimulation. Using a different methodology, namely 3D representation of the VTA by the directional postoperative stimulation through a stationary electrode, our study brings additional arguments in favor of a reorganization of the VP thalamic somatotopy in patients suffering from chronic neuropathic pain of central or peripheral origin.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estimulación Encefálica Profunda / Neuralgia Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Clin Transl Neurol Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estimulación Encefálica Profunda / Neuralgia Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Clin Transl Neurol Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos