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A 50\u2010year\u2010old patient underwent a left medullary infarct leading to right\u2010sided thermal and pain hypaesthesia up to the third right trigeminal division, as well as in the left face. During the following months the patient developed neuropathic pain limited to the left side of the face. Although the territory with sensory loss was much wider in the right (non painful) than in the left (painful) side of the body, PET\u2010scan demonstrated significant reduction of blood flow in the right thalamus (contralateral to the small painful area) relative to its homologous region. After 3 months of right motor cortex stimulation the patient reported 60% relief of his left facial pain, and a new PET\u2010scan showed correction of the thalamic asymmetry. We conclude that thalamic PET\u2010scan hypoactivity contralateral to neuropathic pain does not merely reflect deafferentation, but appears related to the pain pathophysiology, and may be normalized in parallel with pain relief. The possible mechanisms linking thalamic hypoactivity and pain are discussed in relation with findings in epileptic patients, possible compensation phenomena and bursting thalamic discharges described in animals and humans. Restoration of thalamic activity in neuropathic pain might represent one important condition to obtain successful relief by analgesic procedures, including cortical neurostimulation.<\/jats:p>","DOI":"10.1016\/j.ejpain.2005.10.008","type":"journal-article","created":{"date-parts":[[2005,12,10]],"date-time":"2005-12-10T14:06:00Z","timestamp":1134223560000},"page":"677-677","source":"Crossref","is-referenced-by-count":42,"title":["On the relation between sensory deafferentation, pain and thalamic activity in Wallenberg's syndrome: A PET\u2010scan study before and after motor cortex stimulation"],"prefix":"10.1002","volume":"10","author":[{"given":"Luis","family":"Garcia\u2010Larrea","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Maarrawi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Peyron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Costes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Mertens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Magnin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Laurent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410220407"},{"key":"e_1_2_6_3_1","first-page":"691","volume-title":"Advances in pain research and therapy","author":"Albe\u2010Fessard D.","year":"1983"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1006\/nimg.2000.0620"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8619(05)70104-3"},{"key":"e_1_2_6_6_1","first-page":"3788","article-title":"Reduced metabolism in cerebral cortex correlates with MRI changes and cognitive dysfunction in patients with disseminated sclerosis","volume":"163","author":"Blinkenberg M.","year":"2001","journal-title":"Ugeskr Laeger"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(89)90128-0"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.61.1.62"},{"key":"e_1_2_6_9_1","first-page":"1614","article-title":"Performance evaluation of a whole\u2010body PET scanner using the NEMA protocol. 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