Zona Incerta: Target of Electrical Neurostimulation for Neuropathic Pain

Abstract

Neuropathic pain is a neurological condition caused by damage or disease affecting the central nervous system, which includes the brain, brainstem, and spinal cord. Neuropathic pain commonly manifests as spontaneous, ongoing pain and has various causes including stroke, multiple sclerosis, tumors, epilepsy, brain or spinal cord trauma, and Parkinson’s disease. Because of the limitations and side effects associated with the pharmacological treatment of neuropathic pain, neuroscientists have suggested electrical neurostimulation for pain relief. Electrical neurostimulation procedures such as deep brain stimulation and motor cortex stimulation can regulate neuropathic symptoms in movement disorders, psychiatric diseases, and central pain disorders. However, identifying the appropriate target is necessary to maximize the effectiveness of electrical stimulation. Previous studies have described the incertothalamic pathway for the regulation of nociceptive processing in the thalamus. In this pathway, the inhibitory nucleus zona incerta, a GABAergic nucleus located in the diencephalon, suppresses responses in the posterior medial thalamus. This article will review regulation of neuropathic pain with electrical neurostimulation, focusing on the antinociceptive effects of zona incerta activation.