Long-term efficacy of motor cortex stimulation for central post-stroke pain
GUO Song
REN Zhiwei
LI Jianyu
ZHU Hongwei
HU Yongsheng
Abstract：Objective To investigate the long-term efficacy of motor cortex stimulation(MCS)in the treatment of central post-stroke pain(CPSP).Methods The clinical data of 47 patients with CPSP treated with MCS in the Department of Functional Neurosurgery,Xuanwu Hospital,Capital Medical University,between January 2012 and December 2022 were ret-rospectively analyzed.Postoperative follow-up ranged from 12 to 132 months(mean 69.27±28.32 months).Pain intensity and characteristics were assessed preoperatively and at the final follow-up using the Visual Analog Scale(VAS)score and the Neuro-pathic Pain Symptom Inventory(NPSI)score,respectively.Patient sleep quality was evaluated using the Pittsburgh Sleep Quality Index(PSQI).Pain reduction exceeding 40%was considered effective.Results At the final follow-up,the VAS score showed a significant decrease compared to the preoperative score(P<0.001),with a pain relief rate of(45.2±23.1)%.Thirty-nine patients(83%)demonstrated good therapeutic outcomes,while 8 patients(17%)had poor outcomes,among whom 2 underwent device removal due to unsatisfactory response to MCS.At the final follow-up,the total NPSI score and its sub-items including sponta-neous burning pain and paroxysmal pain attacks showed significant improvement(P<0.05),whereas the other three NPSI sub-items showed no statistically significant difference(P>0.05).The PSQI score at the final follow-up was significantly lower than the preoperative score(P<0.001).Among the 39 patients with good surgical outcomes,36 reduced their analgesic usage,while 3 showed no significant change.Among the 8 patients with poor surgical response,5 showed no significant change in analgesic use,and 3 required an increased dosage of analgesic medications.Conclusion For patients with drug-refractory CPSP,MCS can effectively alleviate pain intensity and reduce postoperative analgesic use.Greater improvement is observed in patients whose pain characteristics include spontaneous burning pain and paroxysmal pain attacks.Furthermore,MCS treatment can im-prove the sleep quality of CPSP patients.
Keywords：central post-stroke painmotor cortex stimulationlong-term efficacy
Publication Date：2025-11-25
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：4( 645-648 )