The Anterior Cingulate Cortex (ACC) is a key structure in human pain perception, being part of a central pain neuromatrix. Moreover, it has been shown that the ACC is important for the emotional experience and thus the subjective intensity of pain, and it has a role in cognitive control processes for optimizing behaviour in the presence of pain.
Bilateral anterior cingulotomy has been demonstrated to be a safe and effective therapeutic option for patients with otherwise intractable pain syndromes of different origins, but there remains a lack of evidence in patients with spinal cord injury (SCI).
Moreover, the effects of cingulotomy on mood, emotion processing, cognition and autonomic reactivity are not clear.
Cingulotomy for refractory neuropathic pain in spinal cord injury (CRNP-SCI) aims to answer these questions.