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• W2017304108 abstract "We describe a new neuronavigation-guided technique to target the posterior-superior insula (PSI) using a cooled-double-cone coil for deep cortical stimulation. Despite the analgesic effects brought about by repetitive transcranial magnetic stimulation (TMS) to the primary motor and prefrontal cortices, a significant proportion of patients remain symptomatic. This encouraged the search for new targets that may provide stronger pain relief. There is growing evidence that the posterior insula is implicated in the integration of painful stimuli in different pain syndromes and in homeostatic thermal integration. The primary motor cortex representation of the lower leg was used to calculate the motor threshold and thus, estimate the intensity of PSI stimulation. Seven healthy volunteers were stimulated at 10 Hz to the right PSI and showed subjective changes in cold perception. The technique was safe and well tolerated. The right posterior-superior insula is worth being considered in future studies as a possible target for rTMS stimulation in chronic pain patients. Nous décrivons une nouvelle technique de stimulation non invasive de l’insula postéro-supérieure basée sur la SMTr profonde guidée par neuronavigation. Même si la stimulation magnétique transcrânienne rapide (SMTr) des cortex moteur et préfrontal possède des effets antalgiques incontestables, elle s’avère inefficace dans une proportion significative de patients présentant des douleurs chroniques. Il existe par ailleurs des arguments de plus en plus forts suggérant que l’insula postérieure n’est pas uniquement impliquée dans les processus d’intégration homéostatique thermique, mais également dans l’intégration de la perception de la douleur. La représentation corticale motrice de membres inférieurs a été utilisée pour estimer l’intensité de stimulation de l’insula. Sept volontaires sains ont été stimulés à 10 Hz sur l’insula postérieure et ont montré des changements subjectifs de la perception du froid. La technique s’est avérée non dangereuse pour les paramètres choisis. Cette étude préliminaire suggère qu’une évaluation plus approfondie des effets de la SMT de l’insula postérieure pourrait apporter de nouvelles possibilités dans le traitement des douleurs chroniques." @default.
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• W2017304108 date "2012-12-01" @default.
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• W2017304108 title "Into the Island: A new technique of non-invasive cortical stimulation of the insula" @default.
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• W2017304108 doi "https://doi.org/10.1016/j.neucli.2012.08.003" @default.
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