"Stimulating the Cerebral Motor Cortex May Alleviate Post-Stroke Neuropathic Pain"

Functional Connectivity Between Stroke Lesion and Cerebral Motor Cortex Confirmed
Stimulation of the Motor Cortex Reduces Pain by 30%

[Asia Economy Reporter Lee Gwan-joo] A study has found that stimulating the cerebral motor cortex can alleviate neuropathic pain, a sequela of stroke.

Professor Kim Yong-wook of the Department of Rehabilitation Medicine at Severance Rehabilitation Hospital, Professor Kim Na-young of the Department of Rehabilitation Medicine at Yongin Severance Hospital, and Professor Mike Fox’s research team from the Department of Neurology at Harvard Medical School announced on the 19th that neuropathic pain that may occur after a stroke can be reduced based on the connectivity between the stroke lesion site and the cerebral motor cortex.

After a stroke caused by blockage or rupture of cerebral blood vessels, sequelae such as motor, speech, and cognitive impairments may occur. Neuropathic pain, which causes burning or tingling sensations in the area of motor paralysis, is also one of the sequelae. When the pain becomes chronic, it can lead to sleep disorders and emotional disturbances, lowering the quality of life.

The research team compared brain magnetic resonance imaging (MRI) and positron emission tomography (PET) results of 106 stroke patients from Severance Hospital who complained of neuropathic pain with those of 1,000 healthy individuals to identify lesion characteristics and treatment possibilities.

As a result, they confirmed that treatment strategies could be established by discovering target treatment sites through the strength of functional connectivity, which is the signal transmission pattern between the stroke lesion causing neuropathic pain and other brain regions. In particular, the stroke lesion causing neuropathic pain showed functional connectivity with the cerebral motor cortex. The cerebral motor cortex is the part of the brain’s outer surface responsible for controlling body movement. The research team also found that the stronger the functional connectivity between the two areas, the more the glucose metabolism, the energy source for brain cell activity in the cerebral motor cortex, decreased.

Based on these analytical results, the research team identified target treatment sites and specifically located the cerebral motor cortex area with strong functional connectivity to the stroke lesion in seven patients suffering from neuropathic pain after stroke. They then conducted transcranial magnetic stimulation therapy, which directly stimulates the targeted area with magnetic fields, for two weeks. As a result, neuropathic pain significantly decreased by 30% in 85% of the patients compared to before treatment.

Professor Kim said, "We confirmed that stimulating the cerebral motor cortex, which shows a particularly strong correlation with the stroke lesion site, reduces pain," adding, "This study has laid the groundwork for more precise, non-invasive, personalized treatment for stroke patients."

The study results were published in the prestigious international journal Annals of Neurology (IF 11.274).

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