Neuromodulation : journal of the International Neuromodulation Society
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Development of effective chronic pain treatment strategies has been hampered by the lack of an objective pain biomarker. Magnetoencephalography (MEG) has demonstrated cortical disorganization corresponding to the affected limb of complex regional pain syndrome (CRPS) patients and spinal cord stimulation (SCS) can acutely treat CRPS in a reversible and adjustable fashion. In order to better define a potential MEG-sensitive biomarker for chronic pain, our goal was to study the effects of therapeutic SCS on cortical disorganization in patients with unilateral limb CRPS. ⋯ This is the first report of a MEG study showing D1/D5 cortical disorganization and its apparent reversal or restoration with cervical SCS therapy. Ours also is the first report of an apparent acute reversible interchange in the cortical representations of D1 and D5. Our limited data demonstrate that disorganization of SI cortex might be a neurophysiologic marker of chronic pain as shown with instantaneous normalization of SI disorganization or restoration of SI organization with therapeutic SCS. As a clinically proven tool for functional mapping, MEG might be shown to provide an objective measure of chronic pain. More data are required to further investigate this possibility.