Brief description: Although the exact mechanisms of pain relief through motor cortex stimulation remain elusive, much has been learned in the last 10 years. In this talk we shall explore what is currently known about the neurophysiological and metabolic actions of this type of cortical stimulation, and will compare the local and distant effects of direct (epidural) versus transcranial (magnetic) modes of application. It will be shown that a number of commonalities exist between both modes, especially in their distant effects, whereas local changes in sensorimotor cortex are most probably dissimilar. An intriguing common aspect of both epidural (and transcranial (rTMS) modes of stimulation is the participation of opioid mechanisms in their long-lasting effects.
Luis GARCIA-LARREA, CRNL/Neuropain