Brain activity modifications following spinal cord stimulation for chronic neuropathic pain:a systematic review

Bentley, L.D., Duarte, R.V., Furlong, P.L., Ashford, R.L. and Raphael, J.H. (2016). Brain activity modifications following spinal cord stimulation for chronic neuropathic pain:a systematic review. European Journal of Pain, 20 (4), pp. 499-511.

Abstract

Background and objective: Spinal cord stimulation (SCS) is believed to exert supraspinal effects; however, these mechanisms are still far from fully elucidated. This systematic review aims to assess existing neurophysiological and functional neuroimaging literature to reveal current knowledge regarding the effects of SCS for chronic neuropathic pain on brain activity, to identify gaps in knowledge, and to suggest directions for future research. Databases and data treatment: Electronic databases and hand-search of reference lists were employed to identify publications investigating brain activity associated with SCS in patients with chronic neuropathic pain, using neurophysiological and functional neuroimaging techniques (fMRI, PET, MEG, EEG). Studies investigating patients with SCS for chronic neuropathic pain and studying brain activity related to SCS were included. Demographic data (age, gender), study factors (imaging modality, patient diagnoses, pain area, duration of SCS at recording, stimulus used) and brain areas activated were extracted from the included studies. Results: Twenty-four studies were included. Thirteen studies used neuroelectrical imaging techniques, eight studies used haemodynamic imaging techniques, two studies employed both neuroelectrical and haemodynamic techniques separately, and one study investigated cerebral neurobiology. Conclusions: The limited available evidence regarding supraspinal mechanisms of SCS does not allow us to develop any conclusive theories. However, the studies included appear to show an inhibitory effect of SCS on somatosensory evoked potentials, as well as identifying the thalamus and anterior cingulate cortex as potential mediators of the pain experience. The lack of substantial evidence in this area highlights the need for large-scale controlled studies of this kind.

Publication DOI: https://doi.org/10.1002/ejp.782
Divisions: Life & Health Sciences > Psychology
Life & Health Sciences > Clinical and Systems Neuroscience
Life & Health Sciences > Aston Brain Centre
Life & Health Sciences
Additional Information: This is the peer reviewed version of the following article: Bentley, L. D., Duarte, R. V., Furlong, P. L., Ashford, R. L., & Raphael, J. H. (2015). Brain activity modifications following spinal cord stimulation for chronic neuropathic pain: a systematic review. European journal of pain, Early view, which has been published in final form at http://dx.doi.org/10.1002/ejp.782. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords: Anesthesiology and Pain Medicine
Full Text Link: http://onlineli ... jp.782/abstract
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
Published Date: 2016-04
Authors: Bentley, L.D.
Duarte, R.V.
Furlong, P.L. ( 0000-0002-9840-8586)
Ashford, R.L.
Raphael, J.H.

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