Türk Nöroşirürji Dergisi 2019 , Vol 29 , Num 2
Neuromodulation in Central Pain
Ümit Akın DERE1,Ersoy KOCABIÇAK2
1Pamukkale Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Denizli, Türkiye
2Ondokuz Mayıs Üniversitesi, Tıp Fakültesi Hastanesi, Nöromodülasyon Merkezi, Samsun, Türkiye
3Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Samsun, Türkiye
Pain is divided into nociceptive and neuropathic pain. Nociceptive pain is defined as cutting, stabbing pain, which is caused by the action of nociceptors or by pressure. Neuropathic pain is defined as a the burning, shooting pain that occurs after tissue damage. In addition to medical methods, intrathecal therapies and electrical stimulation of the nervous system are used for pain relief. Peripheral nerve stimulation is not sufficiently effective for central pain. Studies have shown that spinal cord stimulation is less effective for central pain control than stimulation of the thalamus or motor cortex. Central pain therapy can be discussed in three sections. The first one includes the various pharmacological approaches such as antidepressant, anticonvulsant and analgesic drugs. Another treatment modality is the interventional procedures called ablative or lesion surgery, such as thalamotomy, cordotomy and DREZ lesion formation. The third and last section includes the neuromodulation methods, which will be explained here. These include transcutaneous electrical nerve stimulation, spinal cord stimulation, deep brain stimulation, and superficial stimulation of the motor cortex. Deep brain stimulation and superficial stimulation of the motor cortex can be said to be the most effective neuromodulation methods for reducing central neuropathic pain. Anahtar Kelimeler : Central pain, Neuromodulation, Deep brain stimulation, Neuropathic pain