Abstract
Neuropathic pain (NP) may become refractory to conservative medical management, necessitating neurosurgical procedures in carefully selected cases. In this context, the functional neurosurgeon must have suitable knowledge of the disease he or she intends to treat, especially its pathophysiology. This latter factor has been studied thanks to advances in the functional exploration of NP, which will be detailed in this review. The study of the flexion reflex is a useful tool for clinical and pharmacological pain assessment and for exploring the mechanisms of pain at multiple levels. The main use of evoked potentials is to confirm clinical, or detect subclinical, dysfunction in peripheral and central somato-sensory pain pathways. LEP and SEP techniques are especially useful when used in combination, allowing the exploration of both pain and somato-sensory pathways. PET scans and fMRI documented rCBF increases to noxious stimuli. In patients with chronic NP, a decreased resting rCBF is observed in the contralateral thalamus, which may be reversed using analgesic procedures. Abnormal pain evoked by innocuous stimuli (allodynia) has been associated with amplification of the thalamic, insular and SII responses, concomitant to a paradoxical CBF decrease in ACC. Multiple PET studies showed that endogenous opioid secretion is very likely to occur as a reaction to pain. In addition, brain opioid receptors (OR) remain relatively untouched in peripheral NP, while a loss of ORs is most likely to occur in central NP, within the medial nociceptive pathways. PET receptor studies have also proved that antalgic Motor Cortex Stimulation (MCS), indicated in severe refractory NP, induces endogenous opioid secretion in key areas of the endogenous opioid system, which may explain one of the mechanisms of action of this procedure, since the secretion is proportional to the analgesic effect.
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References
Adler LJ, Gyulai FE, Diehl DJ et al. (1997) Regional brain activity changes associated with fentanyl analgesia elucidated by positron emission tomography. Anesth Analg 84: 120–126
Allison T, McCarthy G, Wood CC et al. (1989) Human cortical potentials evoked by stimulation of the median nerve II. Cytoarchitectonic areas generating long-latency activity. J Neurophysiol 62: 711–722
Amantini A, Lombardi M, de Scisciolo G et al. (1996) CO2-laser and electric somato-sensory evoked potentials in Friedreich’s ataxia. Electroenceph Clin Neurophysiol 46 (Suppl): 233–240
Andersen G, Vestergaard K, Ingeman-Nielsen M, Jensen TS (1995) Incidence of central post-stroke pain. Pain 61(2): 187–193
Arendt-Nielsen L (1990) Second pain event related potentials to argon laser stimuli: recording and quantification. J Neurol Neurosurg Psychiatry 53: 405–410
Baron R, Baron Y, Disbrow E, Roberts TPL (1999) Brain processing of capsaicin-induced secondary hyperalgesia. A functional MRI study. Neurology 53: 548–557
Becker DE, Yingling CD, Fein G (1993) Identification of pain, intensity and P300 components in the pain evoked potential. Electroenceph Clin Neurophysiol 88: 290–301
Beydoun A, Dyke DB, Morrow TJ, Casey KL (1996) Topical capsaicin selectively attenuates heat pain and A delta fiber-mediated laser-evoked potentials. Pain 65: 189–196
Boivie J, Leijon G, Johansson I (1989) Central post-stroke pain — a study of the mechanisms through analyses of the sensory abnormalities. Pain 37: 173–185
Bouhassira D, Le Bars D, Bolgert F, Laplane D, Willer JC (1993) Diffuse noxious inhibitory controls in humans: a neurophysiological investigation of a patient with a form of Brown-Sequard syndrome. Ann Neurol 34: 536–543
Boulu P, De Broucker T, Maitre P, Meunier S, Willer JC (1985) Somatosensory evoked potential and pain. I. Late cortical responses obtained at different levels of stimulation. Rev Electroenceph Neurophysiol Clin 15: 19–25
Boureau F, Willer JC, Albe-Fessard D (1978) Role played in man by myelinated fibers of different diameters for the evocation of a nociceptive flex reflex and the accompanying pain sensation. CR Acad Sci Hebd Seances Acad Sci D 16: 1375–1378
Boureau F, Willer JC, Dehen H (1977) The action of acupuncture on pain. Physiological basis. Nouv Presse Med 6: 1871–1874
Boureau F, Sebille A, Willer JC et al. (1978) Effects of percutaneous heterosegmental electric stimulation (electroacupuncture) on the nociceptive flexion reflex in man. Ann Anesthesiol Fr 19: 422–426
Bowsher D (1996) Central pain: clinical and physiological characteristics. J Neurol Neurosurg Psychiatry 61: 62–69
Bragard D, Chen ACN, Plaghki L (1996) Direct isolation of ultra-late (C-fibre) evoked brain potentials by CO2 laser stimulation of tiny cutaneous surface areas in man. Neurosci Lett 209: 81–84
Bromm B, Frieling A, Lankers J (1991) Laser-evoked brain potentials in patients with dissociated loss of pain and temperature sensibility. Electroenceph Clin Neurophysiol 80: 284–291
Bromm B, Treede RD (1984) Nerve fibers discharges, cerebral potentials and sensations induced by CO2 laser stimulation. Hum Neurobiol 3: 33–40
Bromm B, Treede RD (1987) Pain related cerebral potentials: late and ultralate components. Int J Neurosci 33: 15–23
Buchsbaum MS, Davis GC (1979) Application of somatosensory event-related potentials to experimental pain and the pharmacology of analgesia. In: Lehmann D, Callaway E (eds) Human Evoked Potentials. Plenum Press, New York, pp 43–54
Buchsbaum MS, Davis GC, Goodwin FK et al. (1980) Psychophysical pain judgments and somatosensory evoked potentials in patients with affective illness and in normal adults. Adv Biol Psychiatry 4: 63–72
Buckner RL (1998) Event-related fMRI and the hemodynamic response. Hum Brain Map 6: 373–377
Carmichael ST, Price JL (1995) Limbic connections of the orbital and medial prefrontal cortex in macaque monkeys. J Comp Neurol 363(4): 615–641
Carmon A, Dotan Y, Sarne Y (1978) Correlation of subjective pain experience with cerebral evoked responses to noxious thermal stimulations. Exp Brain Res 33: 445–453
Carroll D, Joint C, Maartens N et al. (2000) Motor cortex stimulation for chronic neuropathic pain: a preliminary study of 10 cases. Pain 84: 431–437
Casey KL, Beydoun A, Boivie J et al. (1996) Laser-evoked cerebral potentials and sensory function in patients with central pain. Pain 64: 485–491
Chan CW, Tsang H (1987) Inhibition of the human flexion reflex by low intensity, high frequency transcutaneous electrical nerve stimulation (TENS) has a gradual onset and offset. Pain 28: 239–253
Chapman CR, Colpitts YM, Benedeti C et al. (1980) Evoked potential assessment of acupunctural analgesia: attempted reversal with naloxone. Pain 9: 183–197
Chatrian GE, Canfield RC, Knauss TA, Eegt EL (1975) Cerebral responses to electrical tooth pulp stimulation in man. An objective correlate of acute experimental pain. Neurology 25: 745–757
Cheing GL, Hui-Chan CW (1999) Transcutaneous electrical nerve stimulation: nonparallel antinociceptive effects on chronic clinical pain and acute experimental pain. Arch Phys Med Rehabil 80: 305–312
Chen ACN, Chapman CR (1980) Aspirin analgesia evaluated by even-related potentials in man: possible central action in brain. Exp Brain Res 39: 359–364
Coghill RC, Sang CN, Maisog JM, Iadarola MJ (1999) Pain intensity processing within the human brain: a bilateral, distributed mechanism. J Neurophysiol 82: 1934–1943
Cole JD, Merton WL, Barrett G, Katifi HA, Treede R-D (1995) Evoked potentials in a subject with a large-fiber sensory neuropathy below the neck. Can J Physiol Pharmacol 73: 234–245
Coull JT, Nobre AC (1998) Where and when to pay attention: the neural systems for directing attention to spatial locations and to time intervals as revealed by both PET and fMRI. J Neurosci 18: 7426–7435
Cruccu G, Fornarelli M, Inghilleri M, Manfredi M (1983) The limits of tooth pulp evoked potentials for pain quantitation. Physiol Behav 31: 339–342
Cruccu G, Iannetti GD, Agostino R et al. (2000) Conduction velocity of the human spinothalamic tract as assessed by laser evoked potentials. Neuroreport 11: 3029–3032
Cruccu G, Leandri M, Iannetti GD et al. (2001) Small-fiber dysfunction in trigeminal neuralgia: carbamazepine effect on laser-evoked potentials. Neurology 56: 1722–1726
Cruccu G, García-Larrea L (2004) Clinical utility of laser-evoked potentials. In: Hallett M, Phillips LH, Schomer DL, Massey JM (eds) Advances in evoked potentials. Clinical Neurophysiology Supplement, Vol. 57. Elsevier, Amsterdam, Chap. 12
De Broucker T, Cesaro P, Willer JC, Le Bars D (1990) Diffuse noxious inhibitory controls in man. Involvement of the spinoreticular tract. Brain 113: 1223–1234
Dellemijn PLI, Vanneste JAL (1997) Randomised double blind active-placebo-controlled crossover trial of intravenous fentanyl in neuropathic pain. Lancet 340: 753–758
Dellemijn PLI, VanDuijn H, Vanneste JAL (1998) Prolonged treatment with transderma1 fentanyl in neuropathic pain. J Pain Symptom Manage 16: 220–229
Derbyshire SW, Jones AK, Collins M et al. (1999) Cerebral responses to pain in patients suffering acute postdental extraction pain measured by positron emission tomography (PET). Eur J Pain 3: 103–113
Devor M, Carmon A, Frostig R (1982) Primary afferent and spinal neurons that respond to brief pulses of intense infrared laser radiation: a preliminary survey in rats. Exp Neurol 76: 483–494
Dias RJ, Souza L, Morais WF, Carneiro AP (2004) SEP diagnosing neuropathy of the lateral cutaneous branch of the iliohypogastric nerve: case report. Arq Neuropsiquiatry 62: 895–898
Di Piero V, Jones AK, Iannotti F et al. (1991) Chronic pain: a PET study of the central effects of percutaneous high cervical cordotomy. Pain 46: 9–12
Dostrovsky JO, Hutchison WD, Davis KD, Lozano A (1995) Potential role of orbital and cingulate cortices in nociception. In: Besson JM, Guilbaud G, Ollat H (eds) Forebrain areas involved in pain processing. John Libbey Eurotext, Paris, pp 171–181
Duncan G, Kupers RC, Marchand S et al. (1998) Stimulation of human thalamus for pain relief: possible modulatory circuits revealed by positron emission tomography. J Neurophysiol 80: 3326–3330
Ertekin C, Ertekin N, Karcioglu M (1975) Conduction velocity along human nociceptive reflex afferent nerve fibers. J Neurol Neurosurg Psychiatry 38: 959–965
Esteban A, Traba A (1990) Post-radiation brachial plexus disease. Clinical and neurophysiological study. Arch Neurobiol (Madr) 53: 23–32
Facchinetti F, Sandrini G, Petraglia F et al. (1984) Concomitant increase in nociceptive flexion reflex threshold and plasma opioids following transcutaneous nerve stimulation. Pain 19: 295–303
Fernandes de Lima VM, Chatrian GE, Lettich E et al. (1982) Electrical stimulation of tooth pulp in humans. I. Relationship among physical stimulus intensities, psychological magnitude estimates and cerebral evoked potentials. Pain 14: 207–232
Firestone LL, Gyulai F, Mintun M et al. (1996) Human brain activity response to fentanyl imaged by positron emission tomography. Anesth Analg 82: 1247–1251
García-Larrea L, Charles N, Sindou M, Mauguière F (1993) Flexion reflexes following anterolateral cordotomy in man: dissociation between pain sensation and nociceptive reflex RIII. Pain 55: 139–149
García-Larrea L, Convers P, Magnin M et al. (2002) Laser-evoked potential abnormalities in central pain patients: the influence of spontaneous and provoked pain. Brain 125: 2766–2781
García-Larrea L, Mauguière F (1990) Electrophysiological assessment of nociception in normals and patients: the use of nociceptive reflexes. Electroencephalogr Clin Neurophysiol (Suppl) 41: 102–118
García-Larrea L, Mauguière F (1990) Short-latency somatosensory evoked potentials. In: Colon E, Visser SL (eds) Evoked potential manual. Kluwer Academic, Dordrecht, pp 221–278
García-Larrea L, Peyron R, Laurent B, Mauguière F (1997) Association and dissociation between laser-evoked potentials and pain perception. Neuroreport 8: 3785–3789
García-Larrea L, Peyron R, Mertens P et al. (1999) Electrical stimulation of motor cortex for pain control: a combined PET scan and electrophysiological study. Pain 83: 259–273
García-Larrea L, Peyron R, Mertens P et al. (2000) Functional imaging and neurophysiological assessment of spinal and brain therapeutic modulation in humans. Arch Med Res 31: 248–257
García-Larrea L, Sindou M, Mauguière F (1989) Clinical use of nociception flexion reflex recording in the evaluation of functional neurosurgical procedures. Acta Neurochir (Suppl) 46: 53–57
García-Larrea L, Sindou M, Mauguière F (1989) Nociceptive flexion reflexes during analgesic neurostimulation in man. Pain 39: 145–156
Graff-Radford NR, Damasio H, Yamada T et al. (1985) Nonhaemorrhagic thalamic infarction. Clinical, neuropsychological and electrophysiological findings in four anatomical groups defined by computerized tomography. Brain 108: 485–516
Hansen C, Treede RD, Lorenz J et al. (1996) Recovery from brainstem lesions involving the nociceptive pathways: comparison of clinical findings with laser-evoked potentials. J Clin Neurophysiol 13: 330–338
Harkins SW, Chapman CR (1978) Cerebral evoked potentials to noxious dental stimulation: relationship to subjective pain report. Psychophysiology 15: 248–252
Hartmann-von Monakow K, Akert K, Künzle H (1979) Projections of precentral and premotor cortex to the red nucleus and other midbrain areas in macaca fascicularis. Exp Brain Res 34: 91–105
Hautvast RWM, Terhorst GJ, Dejong BM et al. (1997) Relative changes in regional cerebral blood flow during spinal cord stimulation in patients with refractory angina pectoris. Eur J Neurosci 9: 1178–1183
Hsieh JC, Belfrage M, Stone-Elander S, Hansson P, Ingvar M (1995) Central representation of chronic ongoing neuropathic pain studied by positron emission tomography. Pain 63: 225–236
Hugon M (1973) Exteroceptive reflexes to stimulation of the sural nerve in normal man. In: Desmedt JE (ed) New developments in electromyography and clinical neurophysiology, Vol. III. Karger, Basel, pp 713–729
Iadarola MJ, Berman KF, Zeffiro TA et al. (1998) Neural activation during acute capsaicin-evoked pain and allodynia assessed with PET. Brain 121: 931–947
Iadarola MJ, Max MB, Berman KF et al. (1995) Unilateral decrease in thalamic activity observed with positron emission tomography in patients with chronic neuropathic pain. Pain 63: 55–64
Iannetti GD, Truini A, Romaniello A et al. (2003) Evidence of a specific spinal pathway for the sense of warmth in humans. J Neurophysiol 89: 562–570
Iriki A, Tanaka M, Iwamura Y (1996) Attention-induced neuronal activity in the monkey somatosensory cortex revealed by pupillometrics. Neurosci Res 25: 173–181
Itskovich VV, Fei DY, Harkins SW (2000) Psychophysiological and psychophysical responses to experimental pain induced by two types of cutaneous thermal stimuli. Intl J Neurosci 105: 63–75
Jeanmonod D, Magnin M, Morel A (1993) Thalamus and neurogenic pain: physiological, anatomical and clinical data. Neuroreport 4(5): 475–478
Jones AKP, Cunningham VJ, Ha-Kawa S et al. (1994) Changes in central opioid receptor binding in relation to inflammation and pain in patients with rheumatoid arthritis. Br J Rheumatol 33(10): 909–916
Jones AKP, Derbyshire SW (1997) Reduced cortical responses to noxious heat in patients with rheumatoid arthritis. Ann Rheum Dis 56: 601–607
Jones AKP, Watabe H, Cunningham VJ et al. (2004) Cerebral decreases in opioid receptor binding in patients with central neuropathic pain measured by [11C]diprenorphine binding and PET. Eur J Pain 8: 479–485
Kakigi R, Kuroda Y, Neshige R et al. (1992) Physiological study of the spinothalamic tract conduction in multiple sclerosis. J Neurol Sci 107: 205–209
Kakigi R, Kuroda Y, Takashima H et al. (1992) Physiological functions of the ascending spinal tracts in HTLV-I-associated myelopathy (HAM). Electroenceph Clin Neurophysiol 84: 110–114
Kakigi R, Shibasaki H, Ikeda A et al. (1992) Pain-related somatosensory evoked potentials following CO2 laser stimulation in peripheral neuropathies. Acta Neurol Scand 85: 347–352
Kakigi R, Shibasaki H, Kuroda Yet al. (1991) Pain-related somatosensory evoked potentials in syringomyelia. Brain 114: 1871–1889
Kakigi R, Shibasaki H, Tanaka K et al. (1991) CO2 laser-induced pain-related somatosensory evoked potentials in peripheral neuropathies: correlation between electrophysiological and histopathological findings. Muscle Nerve 14: 441–450
Kanda M, Mima T, Xu X et al. (1996) Pain-related somatosensory evoked potentials can quantitatively evaluate hypalgesia in Wallenberg’s syndrome. Acta Neurol Scand 94: 131–136
Landau W, Bishop GH (1953) Pain from dermal, periosteal and fascial endings and from inflammation: electrophysiological study employing different nerve blocks. Arch Neurol Psychiatry 69: 490–504
Lefaucheur JP, Brusa A, Creange A et al. (2002) Clinical application of laser evoked potentials using the Nd:YAG laser. Neurophysiol Clin 32: 91–98
Legrain V, Guérit JM, Bruyer R, Plaghki L (2002) Attentional modulation of the nociceptive processing into the human brain: selective spatial attention, probability of stimulus occurrence, and target detection effects on laser evoked potentials. Pain 99: 21–39
Levinsson A, Garwicz M, Schouenborg J (1999) Sensorimotor transformation in cat nociceptive withdrawal reflex system. Eur J Neurosci 11: 4327–4332
Lorenz J, Hansen HC, Kunze K, Bromm B (1996) Sensory deficits of a nerve root lesion can be objectively documented by somatosensory evoked potentials elicited by painful infrared laser stimulations. A case study. J Neurol Neurosurg Psychiatry 61: 107–110
Lorenz J, García-Larrea L (2003) Contribution of attentional and cognitive factors to laser-evoked potentials (LEPs). Neurophysiol Clin 33: 293–301
Maarrawi J, Peyron R, García-Larrea L (2006) Brain opioid receptor availability differs in central and peripheral neuropathic pain. In: Flor H, Kalso E, Dotrovsky J (eds) Proc 11th World Congress on Pain. IASP Press, Seattle, pp 407–414
Maarrawi J, Peyron R, Mertens P et al. (2007) Differential brain opioid receptor availability in central and peripheral neuropathic pain. Pain 127: 183–194
Maarrawi J, Peyron R, Mertens P et al. (2007) Motor cortex stimulation for pain control induces changes in the endogenous opioid system. Neurology 69(9): 827–834
MacGowan DJL, Janal MN, Clark MC et al. (1997) Central poststroke pain and Wallenberg’s lateral medullary infarction: frequency, character, and determinants in 63 patients. Neurology 49: 120–125
Magerl W, Ali Z, Ellrich J et al. (1999) C- and Aδ-fiber components of heat-evoked cerebral potentials in healthy human subjects. Pain 82: 127–137
Manfredi M (1970) Differential block of conduction of larger fibers in peripheral nerve by direct current. Arch Ital Biol 108: 52–71
Mauguière F, Desmedt JE (1988) Thalamic pain syndrome of Dejerine-Roussy. Differentiation of four subtypes assisted by somatosensory evoked potentials data. Arch Neurol 45: 1312–1320
Mauguière F, Merlet I, Forss N et al. (1997) Activation of a distributed somatosensory cortical network in the human brain. A dipole modelling study of magnetic fields evoked by median nerve stimulation. Part I: Location and activation timing of SEF sources. Electroenceph Clin Neurophysiol 10: 281–289
Mendell JR, Sahenk Z (2003) Clinical practice. Painful sensory neuropathy. N Engl J Med 348(13): 1243–1255
Mertens P, Nuti C, Sindou M et al. (1999) Precentral cortex stimulation for the treatment of central neuropathic pain: results of a prospective study in a 20-patient series. Stereotact Funct Neurosurg 73(1–4): 122–125
Montes C, Magnin M, Maarrawi J et al. (2005) Thalamic ventral posterior infarct with central pain. Changes in spino-thalamic and lemniscal-related responses and the role of VPL and VMpo in thalamic pain. Pain 113: 223–232
Mouraux A, Guérit JM, Plaghki L (2004) Refractoriness cannot explain why C-fiber laser-evoked brain potentials are recorded only if concomitant Adelta-fiber activation is avoided. Pain 112(1–2): 16–26
Nguyen JP, Lefaucher JP, Le Guerinel C et al. (2000) Motor cortex stimulation in the treatment of central and neuropathic pain. Arch Med Res 31(3): 263–265
Opsommer E, Guérit JM, Plaghki L (2003) Exogenous and endogenous components of ultralate (C-fiber) evoked potentials following CO2 laser stimuli to tiny skin surface areas in healthy subjects. Neurophysiol Clin 33: 78–85
Petersson P, Waldenstrom A, Fahraeus C, Schouenborg J (2003) Spontaneous muscle twitches during sleep guide spinal self organization. Nature 424: 72–75
Peyron R, Faillenot I, Mertens P et al. (2007) Motor cortex stimulation in neuropathic pain. Correlations between analgesic effect and hemodynamic changes in the brain. A PET study. Neuroimage 34(1): 310–321
Peyron R, García-Larrea L, Deiber MP et al. (1995) Electrical stimulation of precentral cortical area in the treatment of central pain. Electrophysiological and PET study. Pain 62: 275–286
Peyron R, García-Larrea L, Grégoire MC et al. (1996) Positron Emission Tomography (PET) evidence of Cerebral Blood Flow (CBF) abnormalities in patients with neurological pain after lateral-medullary infarct (Wallenberg’s syndrome WS). VIIIth World Congress on Pain, IASP, Vancouver [abstract].
Peyron R, García-Larrea L, Grégoire MC et al. (1998) Allodynia after lateral-medullary (Wallenberg) infarct. A Positron Emission Tomography (PET) study. Brain 121: 345–356
Peyron R, García-Larrea L, Grégoire MC et al. (1999) Haemodynamic brain responses to acute pain in humans: sensory and attentional networks. Brain 122: 1765–1780
Plaghki L (1998) Complex regional pain syndrome and A-delta impairment. Sever Algia 55: 1
Ploner M, Schmitz F, Freund HJ, Schnitzler A (1999) Parallel activation of primary and secondary somatosensory cortices in human pain processing. J Neurophysiol 81: 3100–3104
Prestor B, Golob P (1999) Intra-operative spinal cord neuromonitoring in patients operated on for intramedullary tumors and syringomyelia. Neurol Res 21: 125–129
Quante M, Lampe F, Hauck M et al. (2003) Laser-evoked potentials: diagnostic approach to the dorsal root. Orthopäde 32: 852–858
Ragazzoni A, Amantini A, Lombardi M et al. (1993) Electric and CO2 laser SEPs in a patient with asymptomatic syringomyelia. Electroenceph Clin Neurophysiol 88: 335–338
Rage M, Plaghki L (2003) Neurophysiological exploration of the chest wall by CO2-laser-evoked potentials. In: Proc 4th Congress Europ Fed IASP Chapters, Prague, p 472
Rainville P, Duncan GH, Price DD et al. (1997) Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science 277: 968–971
Rees G, Howseman A, Josephs O et al. (1997) Characterizing the relationship between BOLD contrast and regional cerebral blood flow measurements by varying the stimulus presentation rate. Neuroimage 6: 270–278
Restuccia D, Di Lazzaro V, Valeriani M et al. (1992) Segmental dysfunction of the cervical cord revealed by abnormalities of the spinal N13 potential in cervical spondylotic myelopathy. Neurology 42: 1054–1063
Restuccia D, Di Lazzaro V, Valeriani M et al. (1996) Spinal responses to median and fibial nerve stimulation and magnetic resonance imaging in intramedullary cord lesions. Neurology 46: 1706–1714
Roby A, Bussel B, Willer JC (1981) Morphine reinforces post-discharge inhibition of alpha-motoneurons in man. Brain Res 222: 209–212
Roby-Brami A, Bussel B, Willer JC, Le Bars D (1987) An electrophysiological investigation into the pain-relieving effects of heterotopic nociceptive stimuli. Probable involvement of a supraspinal loop. Brain 110: 1497–1508
Romaniello A, Cruccu G, Frisardi G, Arendt-Nielsen L, Svensson P (2003) Assessment of nociceptive trigeminal pathways by laser-evoked potentials and laser silent periods in patients with painful temporomandibular disorders. Pain 103: 31–39
Romaniello A, Iannetti GD, Truini A, Cruccu G (2003) Trigeminal responses to laser stimuli. Neurophysiol Clin 33: 315–324
Rosen SD, Paulesu E, Frith CD et al. (1994) Central nervous pathways mediating angina pectoris. Lancet 344: 147–150
Rosen BR, Buckner RL, Dale AM (1998) Event-related functional MRI: past, present, and future. Proc Natl Acad Sci USA 95: 773–780
Rossi A, Decchi B (1994) Flexibility of lower limb reflex responses to painful cutaneous stimulation in standing humans: evidence of load-dependent modulation. J Physiol 481: 521–532
Rossi A, Zalaffi A, Decchi B (1996) Interaction of nociceptive and non-nociceptive cutaneous afferents from foot sole in common reflex pathways to tibialis anterior motoneurones in humans. Brain Res 714: 76–86
Rousseaux M, Cassim F, Bayle B, Laureau E (1999) Analysis of the perception of and reactivity to pain and heat in patients with Wallenberg syndrome and severe spinothalamic tract dysfunction. Stroke 30: 2223–2229
Rowbotham MC, Reisner-Keller LA, Fields HL (1991) Both intravenous lidocaine and morphine reduce the pain of postherpetic neuralgia. Neurology 41(7): 1024–1028
Rowbotham MC, Twilling L, Davies PS et al. (2003) Oral opioid therapy for chronic peripheral and central neuropathic pain. N Engl J Med 348(13): 1223–1232
Sadato N, Yonekura Y, Yamada H et al. (1998) Activation patterns of covert word generation detected by fMRI: comparison with 3D PET. J Comput Assist Tomogr 22: 945–952
Sandrini G, Arrigo A, Bono G, Nappi G (1993) The nociceptive flexion reflex as a tool for exploring pain control systems in headache and other pain syndromes. Cephalalgia 13: 21–27
Sandrini G, Serrao M, Rossi P et al. (2005) The lower limb flexion reflex in humans. Prog Neurobiol 77(6): 353–395
Santiago S, Ferrer T, Espinosa ML (2000) Neurophysiological studies of thin myelinated (A delta) and unmyelinated (C) fibers: application to peripheral neuropathies. Neurophysiol Clin 30: 27–42
Schlereth T, Baumgärtner U, Magerl W et al. (2003) Left hemisphere dominance in early nociceptive processing in the human parasylvian cortex. Neuroimage 20: 437–450
Senapati AK, Huntington PJ, LaGraize SC et al. (2005) Electrical stimulation of the primary somatosensory cortex inhibits spinal dorsal horn neuron activity. Brain Res 1057: 134–140
Serra J, Campero M, Bostock H, Ochoa J (2004) Two types of C nociceptors in human skin and their behavior in areas of capsaicin-induced secondary hyperalgesia. J Neurophysiol 91: 2770–2781
Sikes RW, Vogt BA (1992) Nociceptive neurons in area 24 of rabbit cingulate cortex. J Neurophysiol 68: 1720–1732
Sindou M, Quoex C, Baleydier C (1974) Fiber organization at the posterior spinal cord-rootlet junction in man. J Comp Neurol 153: 15–26
Sindou M, Mertens P, Bendavid U et al. (2003) Predictive value of somatosensory evoked potentials for long-lasting pain relief after spinal cord stimulation: practical use for patient selection. Neurosurgery 52: 1374–1383
Sokoloff L, Reivich M, Kennedy C et al. (1977) The [14C]deoxyglucose method for the measurement of local cerebral glucose utilization: theory, procedure and normal values in the conscious and anesthetized albino rat. J Neurochem 28: 897–916
Sokoloff L, Porter A, Roland P et al. (1991) General discussion. In: Chadwick C, Derek J, Whelan J (eds) Exploring brain functional anatomy with positron emission tomography. Ciba Foundation Symposium 163. Wiley & Sons, London, pp 43–56
Spiegel J, Hansen C, Baumgärtner U et al. (2003) Sensitivity of laser-evoked potentials versus somatosensory evoked potentials in patients with multiple sclerosis. Clin Neurophysiol 114: 992–1002
Synek VM (1986) Diagnostic importance of somatosensory evoked potentials in the diagnosis of thoracic outlet syndrome. Clin Electroenceph 17: 112–116
Synek VM (1987) Short latency somatosensory evoked potentials in patients with painful dysaesthesias in peripheral nerve lesions. Pain 29: 49–58
Talbot JD, Marrett S, Evans AC, Meyer E, Bushnell MC, Duncan GH (1991) Multiple representations of pain in human cerebral cortex. Science 251: 1355–1358
Tarkka IM, Treede RD (1993) Equivalent electrical source analysis of pain-related somatosensory evoked potentials elicited by a CO2-laser. J Clin Neurophysiol 10: 513–519
Tasker RR (1990) Thalamotomy. Neurosurg Clin N Am 1(4): 841–864
Timmermann L, Ploner M, Haucke K et al. (2001) Differential coding of pain intensity in the human primary and secondary somatosensory cortex. J Neurophysiol 86: 1499–1503
Tölle TR, Kaufmann T, Siessmeier T et al. (1 999) Region-specific encoding of sensory and affective components of pain in the human brain: a positron emission tomography correlation analysis. Ann Neurol 45: 40–47
Towell AD, Purves AM, Boyd SG (1996) CO2 laser activation of nociceptive and nonnociceptive thermal afferents from hairy and glabrous skin. Pain 66: 79–86
Tran TD, Inui K, Hoshiyama M et al. (2002) Cerebral activation by the signals ascending through unmyelinated C-fibers in humans: a magnetoencephalographic study. Neuroscience 113: 375–386
Treede RD, Lankers J, Frieling A et al. (1991) Cerebral potentials evoked by painful, laser stimuli in patients with syringomyelia. Brain 114: 1595–1607
Treede RD, Lorenz J, Baumgärtner U (2003) Clinical usefulness of laser-evoked potentials. Neurophysiol Clin 33: 293–302
Treede RD, Lorenz J, Kunze K, Bromm B (1995) Assessment of nociception pathways with laser-evoked potentials in normal subjects and patients. In: Bromm B, Desmedt JE (eds) Pain and the Brain Series: Advances in Pain Research and Therapy 22. Raven Press, New York, pp 377–392
Treede RD, Meier W, Kunze K, Bromm B (1988) Ultralate cerebral potentials as correlates of delayed pain perception: observation in a case of neurosyphilis. J Neurol Neurosurg Psychiatry 51(10): 1330–1333
Treede RD, Meyer RA, Raja SN, Campbell JN (1995) Evidence for two different heat transduction mechanisms in nociceptive primary afferents innervating monkey skin. J Physiol 483: 747–758
Truini A, Cruccu G, García-Larrea L (2003) Painful sensory neuropathy. N Engl J Med 349: 306–307
Truini A, Haanpaa M, Zucchi R et al. (2003) Laser-evoked potentials in post-herpetic neuralgia. Clin Neurophysiol 114: 702–709
Truini A, Rossi P, Galeotti F, Romaniello A, Virtuoso M, De Lena C, Leandri M, Cruccu G (2004) Excitability of the A-delta nociceptive pathways as assessed by the recovery cycle of laser evoked potentials in humans. Exp Brain Res 155: 120–123
Tsubokawa T, Katayama Y, Yamamoto T et al. (1991) Chronic motor cortex stimulation for the treatment of central pain. Acta Neurochir Suppl (Wien) 52: 137–139
Turner R (1992) Magnetic resonance imaging of brain function. Am J Physiol Imaging 7: 136–145
Urban PP, Hansen C, Baumgärtner U et al. (1999) Abolished laser-evoked potentials and normal blink reflex in midlateral medullary infarction. J Neurol 246: 347–352
Valeriani M, Restuccia D, Di Lazzaro V et al. (1999) Inhibition of the human primary motor area by painful heat stimulation of the skin. Clin Neurophysiol 110: 1475–1880
Valeriani M, Restuccia D, Le Pera D et al. (2002) Attention-related modifications of ultralate CO(2) laser evoked potentials to human trigeminal nerve stimulation. Neurosci Lett 329: 329–333
Vestergaard K, Nielsen J, Andersen G et al. (1995) Sensory abnormalities in consecutive, unselected patients with central poststroke pain. Pain 61: 177–186
Villanueva L, Le Bars D (1995) The activation of bulbo-spinal controls by peripheral nociceptive inputs: diffuse noxious inhibitory controls. Biol Res 28: 113–125
Willer JC, Boureau F, Albe-Fessard D (1977) Role of large diameter cutaneous afferents in transmission of nociceptive messages: electrophysiological study in man. Brain Res 152: 358–364
Willer JC, Bussel B (1980) Evidence for a direct spinal mechanism in morphine-induced inhibition of nociceptive reflexes in humans. Brain Res 187: 212–215
Willer JC, Dehen H, Cambier J (1986) Study of pain thresholds by recording flexor reflexes in thalamic syndromes. Rev Neurol (Paris) 142: 303–307
Willer JC, Roby A, Le Bars D (1984) Psychophysical and electrophysiological approaches to the pain-relieving effects of heterotopic nociceptive stimuli. Brain 107: 1095–1112
Willer JC (1977) Comparative study of perceived pain and nociceptive flexion reflex in man. Pain 3: 69–80
Willer JC (1983) Nociceptive flexion reflex as a tool for pain research in man. In: Desmedt JE (ed) Advances in Neurology. Raven Press, New York, pp 809–827
Willer JC (1990) Clinical exploration of nociception with the use of reflexologic techniques. Neurophysiol Clin 20: 335–356
Willoch F, Tölle TR, Wester HJ et al. (1999) Central pain after pontine infarction is associated with changes in opioid receptor binding: a PET study with 11C-diprenorphine. Am J Neuroradiol 20: 686–690
Willoch F, Schindler F, Wester HJ et al. (2004) Central poststroke pain and reduced opioid receptor binding within pain processing circuitries: a [11C]diprenorphine PET study. Pain 108(3): 213–220
Wu Q, García-Larrea L, Mertens P et al. (1999) Hyperalgesia with reduced laser evoked potentials in neuropathic pain. Pain 80: 209–214
Yamamoto M, Kachi T, Igata A (1995) Pain-related and electrically stimulated somatosensory evoked potentials in patients with stroke. Stroke 26: 426–429
Yamamoto M, Kachi T, Yamada T, Nagamatsu M, Sobue G (1997) Sensory conduction study of cisplatin neuropathy: preservation of small myelinated fibers. Intern Med 36: 829–833
Zimmermann M (1968) Dorsal root potentials after C-fiber stimulation. Science 160: 896–898
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Maarrawi, J., Mertens, P., Peyron, R., Garcia-larrea, L., Sindou, M. (2011). Functional exploration for neuropathic pain. In: Pickard, J.D., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 37. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0673-0_2
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