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The role of the caudate nucleus in acupuncture analgesia was studied in 17 patients receiving caudate stimulation through chronic implanted electrodes to relieve intractable pain caused by late malignancy. Electrical stimulation of the head of the caudate nucleus provided relief from intractable pain in all 17 patients. The pain and pain tolerance threshold were elevated, the alteration in skin galvanic activity, respiratory movement and fingertip plethysmography elicited by a given painful stimulus were depressed. The analgesia required a period of induction and persisted for some time after cessation of stimulation; it showed no obvious segmental topography. These characteristics are similar to those observed in acupuncture analgesia. The effect of caudate stimulation was similar to that of electric needling in depressing the late component of the somatosensory evoked potentials (SEPs) recorded over the scalp and from the centrum medianum of the thalamus. Evoked potentials could be recorded from the caudate nucleus when an acupuncture point was electrically stimulated. The evoked potential record was a complex wave of positive and negative components, the peak latencies of main components being 100-180 msec for positive wave and 148-332 msec for negative wave components. The present study supports the supposition that the caudate nucleus may play a role in acupuncture analgesia. The possibility that the effect of caudate stimulation is brought on by inhibiting the activity of the medial thalamus is discussed.
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