The Current State of Deep Brain Stimulation for Chronic Pain and Its Context in Other Forms of Neuromodulation

Overview

Journal Brain Sci

Publisher MDPI

Date 2018 Aug 22

PMID 30127290

Citations 31

Authors

Sarah Marie Farrell

Alexander Green

Tipu Aziz

Affiliations

Soon will be listed here.

Abstract

Chronic intractable pain is debilitating for those touched, affecting 5% of the population. Deep brain stimulation (DBS) has fallen out of favour as the centrally implantable neurostimulation of choice for chronic pain since the 1970⁻1980s, with some neurosurgeons favouring motor cortex stimulation as the 'last chance saloon'. This article reviews the available data and professional opinion of the current state of DBS as a treatment for chronic pain, placing it in the context of other neuromodulation therapies. We suggest DBS, with its newer target, namely anterior cingulate cortex (ACC), should not be blacklisted on the basis of a lack of good quality study data, which often fails to capture the merits of the treatment.

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References

Lempka S, Malone Jr D, Hu B, Baker K, Wyant A, Ozinga 4th J . Randomized clinical trial of deep brain stimulation for poststroke pain. Ann Neurol. 2017; 81(5):653-663. DOI: 10.1002/ana.24927. View

Boccard S, Prangnell S, Pycroft L, Cheeran B, Moir L, Pereira E . Long-Term Results of Deep Brain Stimulation of the Anterior Cingulate Cortex for Neuropathic Pain. World Neurosurg. 2017; 106:625-637. DOI: 10.1016/j.wneu.2017.06.173. View

Lilford R, Thornton J, Braunholtz D . Clinical trials and rare diseases: a way out of a conundrum. BMJ. 1995; 311(7020):1621-5. PMC: 2551510. DOI: 10.1136/bmj.311.7020.1621. View

North R, Kidd D, Farrokhi F, Piantadosi S . Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial. Neurosurgery. 2004; 56(1):98-106. DOI: 10.1227/01.neu.0000144839.65524.e0. View

Baber Z, Erdek M . Failed back surgery syndrome: current perspectives. J Pain Res. 2016; 9:979-987. PMC: 5106227. DOI: 10.2147/JPR.S92776. View

Katayama Y, Yamamoto T, Kobayashi K, Kasai M, Oshima H, Fukaya C . Motor cortex stimulation for post-stroke pain: comparison of spinal cord and thalamic stimulation. Stereotact Funct Neurosurg. 2002; 77(1-4):183-6. DOI: 10.1159/000064618. View

Pereira E, Paranathala M, Hyam J, Green A, Aziz T . Anterior cingulotomy improves malignant mesothelioma pain and dyspnoea. Br J Neurosurg. 2013; 28(4):471-4. DOI: 10.3109/02688697.2013.857006. View

Richardson D, Akil H . Long term results of periventricular gray self-stimulation. Neurosurgery. 1977; 1(2):199-202. DOI: 10.1097/00006123-197709000-00018. View

Assaf Y, Pasternak O . Diffusion tensor imaging (DTI)-based white matter mapping in brain research: a review. J Mol Neurosci. 2007; 34(1):51-61. DOI: 10.1007/s12031-007-0029-0. View

10.

Pereira E, Boccard S, Aziz T . Deep brain stimulation for pain: distinguishing dorsolateral somesthetic and ventromedial affective targets. Neurosurgery. 2014; 61 Suppl 1:175-81. DOI: 10.1227/NEU.0000000000000397. View

11.

Cosgrove G, Rauch S . Stereotactic cingulotomy. Neurosurg Clin N Am. 2003; 14(2):225-35. DOI: 10.1016/s1042-3680(02)00115-8. View

12.

Strafella A, Vanderwerf Y, Sadikot A . Transcranial magnetic stimulation of the human motor cortex influences the neuronal activity of subthalamic nucleus. Eur J Neurosci. 2004; 20(8):2245-9. DOI: 10.1111/j.1460-9568.2004.03669.x. View

13.

Kumar K, Toth C, Nath R, Laing P . Epidural spinal cord stimulation for treatment of chronic pain--some predictors of success. A 15-year experience. Surg Neurol. 1998; 50(2):110-20; discussion 120-1. DOI: 10.1016/s0090-3019(98)00012-3. View

14.

Fields H, Adams J . Pain after cortical injury relieved by electrical stimulation of the internal capsule. Brain. 1974; 97(1):169-78. DOI: 10.1093/brain/97.1.169. View

15.

Lefaucheur J, Drouot X, Cunin P, Bruckert R, Lepetit H, Creange A . Motor cortex stimulation for the treatment of refractory peripheral neuropathic pain. Brain. 2009; 132(Pt 6):1463-71. DOI: 10.1093/brain/awp035. View

16.

BALLANTINE Jr H, CASSIDY W, FLANAGAN N, Marino Jr R . Stereotaxic anterior cingulotomy for neuropsychiatric illness and intractable pain. J Neurosurg. 1967; 26(5):488-95. DOI: 10.3171/jns.1967.26.5.0488. View

17.

Pereira E, Wang S, Paterson D, Stein J, Aziz T, Green A . Sustained reduction of hypertension by deep brain stimulation. J Clin Neurosci. 2009; 17(1):124-7. DOI: 10.1016/j.jocn.2009.02.041. View

18.

Honey C, Tronnier V, Honey C . Deep brain stimulation versus motor cortex stimulation for neuropathic pain: A minireview of the literature and proposal for future research. Comput Struct Biotechnol J. 2016; 14:234-7. PMC: 4925438. DOI: 10.1016/j.csbj.2016.06.003. View

19.

Levy R, Lamb S, Adams J . Treatment of chronic pain by deep brain stimulation: long term follow-up and review of the literature. Neurosurgery. 1987; 21(6):885-93. DOI: 10.1227/00006123-198712000-00017. View

20.

Jones C, Logan J, Gladden R, Bohm M . Vital Signs: Demographic and Substance Use Trends Among Heroin Users - United States, 2002-2013. MMWR Morb Mortal Wkly Rep. 2015; 64(26):719-25. PMC: 4584844. View