Caloric Vestibular Stimulation: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
Activation of the parieto-insular vestibular cortex (PIVC) is thought to play a role in relieving central pain. There are two hypothesised mechanisms of action for activation of the PIVC | Activation of the parieto-insular vestibular cortex (PIVC) is thought to play a role in relieving central pain. There are two hypothesised mechanisms of action for activation of the PIVC.<ref>McGeoch PD, Williams LE, Lee RR, Ramachandran VS. Behavioural evidence for vestibular stimulation as a treatment for central post-stroke pain. J Neurol Neurosurg Psychiatry. 2008 Nov;79(11):1298-301. doi: 10.1136/jnnp.2008.146738. Epub 2008 Jun 11. PMID: 18550629.</ref> | ||
* Activation of the adjacent thermosensory cortex in the dorsal posterior insula | * Activation of the adjacent thermosensory cortex in the dorsal posterior insula | ||
* Rebalancing integration of thermosensory information by suppressing thermal pain at the anterior cingulate cortex (ACC) | * Rebalancing integration of thermosensory information by suppressing thermal pain at the anterior cingulate cortex (ACC) | ||
There is generally greater and more sustained pain relief in the head and upper limbs than the lower limbs. The best results are seen in those where it is possible to activate the dominant PIVC, located in the non-dominant hemisphere. The vestibular outflow from the thalamus to the PIVC is located in the posterolateral thalamus. | There is generally greater and more sustained pain relief in the head and upper limbs than the lower limbs. The best results are seen in those where it is possible to activate the dominant PIVC, located in the non-dominant hemisphere. The vestibular outflow from the thalamus to the PIVC is located in the posterolateral thalamus. | ||
== Instructions == | |||
==Resources== | ==Resources== | ||
Revision as of 20:25, 31 July 2024
Caloric Vestibular Stimulation is an experimental treatment for central pain syndromes.
Pathophysiology
Activation of the parieto-insular vestibular cortex (PIVC) is thought to play a role in relieving central pain. There are two hypothesised mechanisms of action for activation of the PIVC.[1]
- Activation of the adjacent thermosensory cortex in the dorsal posterior insula
- Rebalancing integration of thermosensory information by suppressing thermal pain at the anterior cingulate cortex (ACC)
There is generally greater and more sustained pain relief in the head and upper limbs than the lower limbs. The best results are seen in those where it is possible to activate the dominant PIVC, located in the non-dominant hemisphere. The vestibular outflow from the thalamus to the PIVC is located in the posterolateral thalamus.
Instructions
Resources
References
- ↑ McGeoch PD, Williams LE, Lee RR, Ramachandran VS. Behavioural evidence for vestibular stimulation as a treatment for central post-stroke pain. J Neurol Neurosurg Psychiatry. 2008 Nov;79(11):1298-301. doi: 10.1136/jnnp.2008.146738. Epub 2008 Jun 11. PMID: 18550629.
