Cingulotomy for Cancer Pain.

IF 2.4 4区 医学 Q3 NEUROIMAGING
Valentina Lind, Harith Akram
{"title":"Cingulotomy for Cancer Pain.","authors":"Valentina Lind, Harith Akram","doi":"10.1159/000548804","DOIUrl":null,"url":null,"abstract":"<p><p>Stereotactic anterior cingulotomy is a neurosurgical technique that can offer significant pain relief in patients with refractory cancer pain, particularly in the palliative setting. Despite being described in the 1960s, its use has recently resurged due to limitations of pharmacologic and neuromodulatory therapies in terminally ill patients. The anterior cingulate cortex plays a crucial role in the affective processing of pain, and its disruption through targeted lesioning may reduce suffering without eliminating nociception. This review summarises the historical background, patient selection criteria, surgical approaches, efficacy data, and safety outcomes associated with bilateral anterior cingulotomy for cancer-related pain. Additionally, the Queen Square approach, incorporating MRI-guided targeting and diffusion imaging, is described. Available data support the procedure's short-term efficacy in the majority of patients, with limited cognitive side effects and minimal morbidity. Future directions include network-based targeting, refinement of lesion techniques, and consideration of non-invasive alternatives such as focused ultrasound. Further research is warranted to optimise selection criteria and understand the neural mechanisms underlying pain relief.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"1-20"},"PeriodicalIF":2.4000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Stereotactic and Functional Neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000548804","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROIMAGING","Score":null,"Total":0}
引用次数: 0

Abstract

Stereotactic anterior cingulotomy is a neurosurgical technique that can offer significant pain relief in patients with refractory cancer pain, particularly in the palliative setting. Despite being described in the 1960s, its use has recently resurged due to limitations of pharmacologic and neuromodulatory therapies in terminally ill patients. The anterior cingulate cortex plays a crucial role in the affective processing of pain, and its disruption through targeted lesioning may reduce suffering without eliminating nociception. This review summarises the historical background, patient selection criteria, surgical approaches, efficacy data, and safety outcomes associated with bilateral anterior cingulotomy for cancer-related pain. Additionally, the Queen Square approach, incorporating MRI-guided targeting and diffusion imaging, is described. Available data support the procedure's short-term efficacy in the majority of patients, with limited cognitive side effects and minimal morbidity. Future directions include network-based targeting, refinement of lesion techniques, and consideration of non-invasive alternatives such as focused ultrasound. Further research is warranted to optimise selection criteria and understand the neural mechanisms underlying pain relief.

癌性疼痛的扣带切开术。
立体定向前扣带切开术是一种神经外科技术,可以为难治性癌症疼痛患者提供显著的疼痛缓解,特别是在姑息治疗中。尽管在20世纪60年代被描述,但由于晚期患者的药理学和神经调节疗法的局限性,它的使用最近又恢复了。前扣带皮层在疼痛的情感处理中起着至关重要的作用,通过有针对性的损伤来破坏它可能会在不消除伤害的情况下减少痛苦。本文综述了双侧前扣带切开术治疗癌症相关疼痛的历史背景、患者选择标准、手术入路、疗效数据和安全性结果。此外,皇后广场方法,结合核磁共振引导的目标和扩散成像,被描述。现有数据支持该手术对大多数患者的短期疗效,认知副作用有限,发病率最低。未来的方向包括基于网络的靶向、病变技术的改进,以及考虑非侵入性替代方法,如聚焦超声。进一步的研究是必要的,以优化选择标准和了解疼痛缓解的神经机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
3.80
自引率
0.00%
发文量
33
审稿时长
3 months
期刊介绍: ''Stereotactic and Functional Neurosurgery'' provides a single source for the reader to keep abreast of developments in the most rapidly advancing subspecialty within neurosurgery. Technological advances in computer-assisted surgery, robotics, imaging and neurophysiology are being applied to clinical problems with ever-increasing rapidity in stereotaxis more than any other field, providing opportunities for new approaches to surgical and radiotherapeutic management of diseases of the brain, spinal cord, and spine. Issues feature advances in the use of deep-brain stimulation, imaging-guided techniques in stereotactic biopsy and craniotomy, stereotactic radiosurgery, and stereotactically implanted and guided radiotherapeutics and biologicals in the treatment of functional and movement disorders, brain tumors, and other diseases of the brain. Background information from basic science laboratories related to such clinical advances provides the reader with an overall perspective of this field. Proceedings and abstracts from many of the key international meetings furnish an overview of this specialty available nowhere else. ''Stereotactic and Functional Neurosurgery'' meets the information needs of both investigators and clinicians in this rapidly advancing field.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信