Functional Neuroanatomy of Pain by Kamen G. Usunoff MD, Anastas Popratiloff MD, Oliver Schmitt

By Kamen G. Usunoff MD, Anastas Popratiloff MD, Oliver Schmitt MD, Andreas Wree MD (auth.)

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Motor Cortex Interestingly, motor cortex stimulation has been shown to be benevolent for chronic pain suppression. Nearly 300 cases of motor cortex stimulation have been published. Although the results were variable, it was applied successfully in central post-stroke pain and in trigeminal neuralgia. The electrode is placed epidurally over the precentral gyrus. By stimulating the precentral cortex, increased neuronal activity was found in the ventroanterior and ventrolateral nuclei of the thalamus.

1995; Westlund and Craig 1996). As Hassler proposed that the pallidum externum is reached by pain-conducting axons (see Fig. 31 in Hassler, 1960), recently Gauriau and Bernard (2004) established that the deep laminae in the rat SC project substantially to the globus pallidus and the substantia innominata. In addition to the multineuronal chains that convey nociceptive information to the hypothalamus and amygdala, there is growing evidence for the existence of direct spino(trigemino)hypothalamic and spino(trigemino)limbic tracts (Burstein and Giesler 1989; Burstein et al.

In the lumbar segments, the cells of origin are located within a narrow band extending across the ipsilateral DH, subjacent to substantia gelatinosa. Hirschberg et al. (1996) reported a population of cells originating in lamina X and overlying dorsal commissural region at the sacral level of the rat SC. Similarly, Wang et al. (1999) found out that in the rat, neurons in the area adjacent to the central canal of the midthoracic or lumbosacral level of the SC send ascending projections to the dorsal, lateral rim of the Gr and the medial rim of Cu or the dorsomedial rim of the Gr, respectively.

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