Pain is usually managed with non-surgical methods such as oral medications, injections and nerve blocks. When these options fail and severe pain turns into a chronic condition, motor cortex stimulation may be the next step for you. Motor cortex stimulation is a not a cure for pain, but it can help significantly relieve your symptoms.

What is motor cortex stimulation?

Motor cortex stimulation is a type of neuromodulation, which is a surgical procedure that implants electrodes in the body to change how the nervous system works. Motor cortex stimulation involves placing the electrodes on the surface of the brain to control pain signals. It is an off-label procedure, which means it is not yet FDA-approved.

Deep brain stimulation is more complex than motor cortex stimulation because it involves implanting a device deep inside the brain rather than on the surface of the brain.

Am I a candidate for motor cord stimulation for pain management?

If medications and other therapies fail to treat your pain symptoms, your doctor considers surgical options. You may also be a candidate for spinal cord stimulation if you experience:

• Post-stroke pain
• Atypical varieties of trigeminal neuralgia

What happens during motor cortex stimulation surgery?

Patients are awake for part of the motor cortex stimulation surgery so we can test the electrodes and make sure they are in the right place. A local anesthetic is used. The procedure happens in two stages:

• Stage 1: In preparation for surgery, your doctor will order a functional MRI to map your brain's motor cortex. It will be used to pinpoint the precise area of your brain to target for motor cortex stimulation.

• Stage 2: On the day of surgery, while you are sedated, your neurosurgeon will use frameless navigation to provide a precise roadmap of the brain using the advanced brain imaging studies obtained prior to surgery. Using these images, your neurosurgeon implants an electrode over the targeted area of your brain. You may be woken up during surgery so your surgeon can test the device and you can tell us if you feel stimulation in the right place.

What to expect after motor cortex stimulation

Patients considering motor cortex stimulation should have realistic expectations for results. The surgery relieves symptoms, but it is not a cure. It can also take up to six months of adjustments after surgery for some patients to achieve optimal results. In carefully selected patients, up to 50 percent experience relief from motor cortex stimulation.

Interested in motor cortex stimulation at UCLA? Get prepared for your first appointment.