Summary
This paper reviews the author’s nine years of experience in analgesic brain stimulation. During this time, of 22 patients with pain of peripheral origin who were treated with periaqueductal gray (PAG), stimulation 16 achieved successful control of pain. Of 40 patients who presented with deafferentation pain, 16 were able to control their dysesthesia by brain stimulation of the subcortical somatosensory region alone; follow-up was over a long period. The mechanism of deafferentation pain is poorly understood and the effectiveness of subcortical somatosensory electrical stimulation to relieve such pain is based on empirical observation. The analgesia produced by PAG stimulation appears to be mediated by the release of beta-endorphin from the anterior hypothalamus. The released beta-endorphin binds to the Opiate reeeptors in the PAG and activates the descending pain-inhibitory pathway. However, the repetitive stimulation of this serotonergic system produces tolerance to its analgesic effect, due to a decreased rate of Serotonin turnover. Loading of the serotonin precursor by dietary supplementation of the essential amino acid L-tryptophan reverses this tolerance.
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References
Adams, J. E., Hosobuchi, Y., Fields, H., Stimulation of internal capsule for relief of chronic pain. J. Neurosurg. 41 (1975), 740–744.
Akil, H., Richardson, D. E., Hughes, J., Barchas, J. P., Enkephalin-like material elevated in ventricular cerebrospinal fluid of pain patients after analgesic focal Stimulation. Science 201 (1978), 463–465.
Basbaum, A. L., Field, H. L., Endogenous pain control mechanisms: Review and hypothesis. Anal. Neurol. 4 (1978), 451–462.
Bloom, F., Battenberg, E., Rossier, J., Ling, N., Guillemin, R., Neurons con- taining beta-endorphin in rat brain exist separately from those containing enkephalin: immunocytochemical studies. Proc. Natl. Acad. Sci. U.S.A. 75 (1978), 1591–1595.
Fernstrom, J. D., Nortman, R. J., Control of brain Serotonin levels by the diet. Adv. Biochem. Psychopharmacol. 11 (1974), 133–142.
Gal, E. M., Poczik, M., Marshall, F. D. J., Hydroxylation of tryptophan to 5-hydroxytryptophan by brain tissue in vivo. Biochem. Biophys. Res. Commun. 12 (1963), 39.
Hosobuchi, Y., Pain Control by Activation of the Endorphin System by Periaqueductal Gray Stimulation. In: Current Concepts in the Treatment of Pain. Springfield, III.: Ch. C Thomas (in press).
Hosobuchi, Y., Elevation of Beta-Endorphin-Like Substances and Pro-Opio- cortin (31 K ACTH). In: Alteration in Brain Function, pp. 57–63 (Hitchcock, E. R., ed.). Elsevier: North Holland. 1979.
Hosobuchi, Y., Tryptophan reversal of tolerance to analgesia induced by central gray Stimulation. Lancet 2 (1978), 47.
Hosobuchi, Y., Adams, J. E., Linchitz, R., Pain relief by electrical Stimulation of centray gray matter in humans. Science 197 (1977), 183–186.
Hosobuchi, Y., Adams, J. E., Rutkin, B., Chronic thalamic Stimulation for the control of facial anesthesia dolorosa. Arch. Neurol. 29 (1973), 158–162.
Hosobuchi, Y., Rossier, J., Bloom, J. E., Guillemin, R., Stimulation of human periaqueductal gray for pain relief increases immunoreactive beta-endorphin in ventricular fluid. Science 201 (1979), 279–281.
Hosobuchi, Y., Wemmer, J., Disulfiram inhibition of development of tolerance to analgesia induced by central gray Stimulation in humans. Eur. J. Pharma- col. 43 (1977), 385–387.
Mazars, G. J., Intermittent Stimulation of nucleus ventralis posterolateralis for intractable pain. Surg. Neurol. 4 (1975), 93–95.
Meyerson, B. A., Boethius, J., Terenius, L., Wahlstrom, A., Paper presented at the third meeting of the European Society for Stereotaxic and Functional Neurosurgery, Freiburg, September 19, 1977.
Mundinger, F., Results of brain Stimulation presented at 3rd European Workshop on Neurostimulation., Megeve, France, March 30–31, 1979.
Neff, N. H., Tozer, T. N., Brodie, B. B., Application of steady State kinetics to studies of the transfer of 5-hydroxyindolacetic acid from brain to plasma. J. Pharmacol. Exp. Ther. 158 (1967), 214–218.
Richardson, D. E., Akil, H., Pain reduction by electrical brain Stimulation in man: Chronic self-stimulation in the periaqueductal gray matter. J. Neuro surg. 47 (1977), 184–194.
Rose, J. C., Goldsmith, P. C., Lovinger, R., Anbert, M. C., Kaplan, S. L., Ganong, W. F., Effect of electrical Stimulation of canine diencephalon on the secretion of ACTH, growth hormone (GH), and prolactin (P). Neuroendo- crinology 23 (1979), 223–235.
Rose, J. C., Goldsmith, P. C., Ganong, W. F., Inhibition of stress-induced ACTH secretion by electrical Stimulation of the brain stem in dogs. Fed. Proc. 35 (1976), 1172.
Rossier, J., Vargo, T. M., Minick, S., Ling, N., Bloom, F. E., Guillemin, R., Regional disassociation of beta-endorphin and encephalin contents in rat brain and pituitary. Proc. Natl. Acad. Sci. U.S.A. 74 (1977), 1562–1565.
Van Praag, H. M., Korf, J., Monoamine Metabolism in Depression: Clinical Applications of the Probenecid Test. In: Serotonin and Behavior (Barchas, J., Usedin, E., eds.). New York: Academic Press. 1973.
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Hosobuchi, Y. (1980). The Current Status of Analgesic Brain Stimulation. In: Gillingham, F.J., Gybels, J., Hitchcock, E., Rossi, G.F., Szikla, G. (eds) Advances in Stereotactic and Functional Neurosurgery 4. Acta Neurochirurgica Supplementum, vol 30. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8592-6_27
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DOI: https://doi.org/10.1007/978-3-7091-8592-6_27
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