BACKGROUND: Chronic motor cortex stimulation (MCS) has been used to treat medically refractory @entity9 over the past 20 years. We investigated this procedure using a prospective multicentre randomized blinded crossover trial. METHODS: Twelve subjects with three different @entity9 syndromes had placement of MCS systems after which they were randomized to receive low ("subtherapeutic") or high ("therapeutic") stimulation for 12 weeks, followed by a crossover to the other treatment group for 12 weeks. The primary outcome measure was the @entity158 visual analogue scale (VAS). Secondary outcome measures included McGill @entity158 Questionnaire (MPQ), Beck Depression Inventory-II, medication log, work status, global impression of change, and SF-36 quality of life scale. RESULTS: The trial was halted early due to lack of efficacy. One subject withdrew early due to protocol violation and five subjects withdrew early due to transient adverse events. Six subjects with upper extremity @entity158 completed the study. There was no significant change in VAS with low or high stimulation and no significant improvement in any of the outcome measures from low to high stimulation. SF-36 role physical and mental health scores were worse with high compared to low stimulation (p=0.024, p=0.005). CONCLUSIONS: We failed to show that MCS is an effective treatment for refractory upper extremity @entity9 and suggest that previous studies may have been skewed by placebo effects, or ours by nocebo. We suggest that a healthy degree of skepticism is warranted when considering this invasive therapy for upper extremity @entity158 syndromes.

Motor Cortex Stimulation for XXXX : A Randomized Cross-over Trial.

@entity9 :: ('MESH:D009437', 'Disease') :: ['neuropathic pain'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain', 'Pain']
@entity9 :: (MESH:D009437,Disease) :: ['Neuropathic Pain']
