Motor cortex stimulation modulates defective central beta rhythms in patients with neuropathic pain

ObjectiveMotor cortex stimulation therapy (MCS) is increasingly used to control refractory neuropathic pain. Post-movement beta synchronization (PMBS) is defined as a sharp increase in beta-frequency electroencephalographic power following movement offset and may reflect sensorimotor cortex inhibition induced, at least in part, by cortical processing of movement-related sensory afferent inputs. PMBS pattern is then often altered in case of neuropathic pain. The main objective of the present study was to test the hypothesis that implanted MCS modulates PMBS in patients presenting with neuropathic pain.MethodsUsing a high-resolution, 128-electrode electroencephalographic system, we recorded and compared, before and during MCS, PMBS patterns during brisk, unilateral right and left index finger extension in 8 patients presenting with neuropathic pain.ResultsThe pre-operative PMBS patterns were altered in all cases. MCS increased the spatial distribution and amplitude of PMBS in most of cases and restored maximum-intensity of PMBS contralateral to the painful body side. These modifications appeared significantly correlated with the analgesic effect of MCS.ConclusionThis study provides evidence of central beta rhythms neuromodulation induced by MCS.SignificanceThe restoration by MCS of defective cortical inhibition in patients with neuropathic pain is evoked.

► Post-movement beta synchronization (PMBS) was altered in patients presenting with neuropathic pain. ► Electrical motor cortex stimulation (MCS) restored a more physiological pattern of PMBS in patients presenting with neuropathic pain. ► This restoration of PMBS pattern was correlated with the analgesic effect of MCS.