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Fig. 9 | Bioelectronic Medicine

Fig. 9

From: Spinal cord stimulation in chronic pain: evidence and theory for mechanisms of action

Fig. 9

Chronic pain thalamocortical dysrhythmia is known to occur in distinct band, i.e. most commonly in theta, beta, and gamma bands. Work from De Ridder and Vannesste demonstrate p < .0001) with greatest differences found in theta-beta theta and gamma (Panel a), source localized to bilateral sensory discriminative pathways SI, which additional affective emotional pathways including dACC, sgACC, bilateral INS, bilateral PHC, and posterior cingulate cortex (Panel b). Pretrial and or implant characterization of chronic pain patient TCD could inform the practitioner of an optimal SCS paradigm, while post SCS TCD measures could track SCS efficacy (i.e., decrease in predominate θ theta, β beta, γ gamma dysrhythmias) as described by Schulman et al. (2005). dACC dorsal anterior cingulate cortex, sgACC subgenual anterior cingulate cortex, INS insula, PHC parahippocampus, SI primary somatosensory cortex, PCC posterior cingulate cortex, θ theta, α alpha, β beta, γ gamma. Figure adapted from Vanneste et al. (2018) Nature Communications (Vanneste et al., 2018)

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