Single Electrode Deep Brain Stimulation with Dual Targeting at Dual Frequency for the Treatment of Chronic Pain: A Case Series and Review of the Literature

Hollingworth, Milo; Sims-Williams, Hugh P; Pickering, Anthony E.; Barua, Neil; Patel, Nikunj K.

doi:10.3390/brainsci7010009

Cited by 21 publications

(15 citation statements)

References 44 publications

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“…In several studies, the CM nucleus has been suggested as a potentially effective DBS target for the treatment of Parkinson's disease (Caparros-Lefebvre et al, 1999;Mazzone et al, 2006;Peppe et al, 2008;Stefani et al, 2009) and Tourette syndrome (Houeto et al, 2005;Savica et al, 2012;Marano et al, 2019). The clinical surgeries targeting at CM also show treatment effect for the generalized epilepsy (Fisher et al, 1992;Velasco et al, 2007;Valentín et al, 2013;Li and Cook, 2018) and intractable neuropathic pain (Young et al, 1995;Hollingworth et al, 2017) by means of DBS or thalamotomy. The DBS surgery targeting the CM nucleus currently uses indirect ways in which a two-dimensional stereotactic atlas of the thalamus is superimposed on a CT or MRI scan relative to coarse anatomical landmarks including anterior and posterior commissures (Stefani et al, 2009;Son et al, 2016;.…”

Section: Discussionmentioning

confidence: 99%

Imaging the Centromedian Thalamic Nucleus Using Quantitative Susceptibility Mapping

Gutierrez

et al. 2020

Front. Hum. Neurosci.

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Section: Discussionmentioning

confidence: 99%

Imaging the Centromedian Thalamic Nucleus Using Quantitative Susceptibility Mapping

Gutierrez

et al. 2020

Front. Hum. Neurosci.

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“…Most were published as individual case reports, although several were part of larger single-group studies (including multiple case reports) that included only one patient with PLP. 81,83,85,96 Five of the cases 84,[89][90][91]97 were reported only as conference abstracts.…”

Section: Case Reportsmentioning

confidence: 99%

“…There were six case reports on SCS, 82,84,88,90-92 six on MCS 81,86,[93][94][95][96] and four on DBS. 83,85,87,97 There was also one case report of SCS and DRG stimulation being undertaken simultaneously 89 and one of MCS followed by DBS. 92 Follow-up time was at least a few months in most reports and several years in many.…”

Section: Case Reportsmentioning

confidence: 99%

Brain and spinal stimulation therapies for phantom limb pain: a systematic review

Corbett

South

Harden

et al. 2018

Health Technol Assess

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Background Although many treatments exist for phantom limb pain (PLP), the evidence supporting them is limited and there are no guidelines for PLP management. Brain and spinal cord neurostimulation therapies are targeted at patients with chronic PLP but have yet to be systematically reviewed. Objective To determine which types of brain and spinal stimulation therapy appear to be the best for treating chronic PLP. Design Systematic reviews of effectiveness and epidemiology studies, and a survey of NHS practice. Population All patients with PLP. Interventions Invasive interventions – deep brain stimulation (DBS), motor cortex stimulation (MCS), spinal cord stimulation (SCS) and dorsal root ganglion (DRG) stimulation. Non-invasive interventions – repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). Main outcome measures Phantom limb pain and quality of life. Data sources Twelve databases (including MEDLINE and EMBASE) and clinical trial registries were searched in May 2017, with no date limits applied. Review methods Two reviewers screened titles and abstracts and full texts. Data extraction and quality assessments were undertaken by one reviewer and checked by another. A questionnaire was distributed to clinicians via established e-mail lists of two relevant clinical societies. All results were presented narratively with accompanying tables. Results Seven randomised controlled trials (RCTs), 30 non-comparative group studies, 18 case reports and 21 epidemiology studies were included. Results from a good-quality RCT suggested short-term benefits of rTMS in reducing PLP, but not in reducing anxiety or depression. Small randomised trials of tDCS suggested the possibility of modest, short-term reductions in PLP. No RCTs of invasive therapies were identified. Results from small, non-comparative group studies suggested that, although many patients benefited from short-term pain reduction, far fewer maintained their benefits. Most studies had important methodological or reporting limitations and few studies reported quality-of-life data. The evidence on prognostic factors for the development of chronic PLP from the longitudinal studies also had important limitations. The results from these studies suggested that pre-amputation pain and early PLP intensity are good predictors of chronic PLP. Results from the cross-sectional studies suggested that the proportion of patients with severe chronic PLP is between around 30% and 40% of the chronic PLP population, and that around one-quarter of chronic PLP patients find their PLP to be either moderately or severely limiting or bothersome. There were 37 responses to the questionnaire distributed to clinicians. SCS and DRG stimulation are frequently used in the NHS but the prevalence of use of DBS and MCS was low. Most responders considered SCS and DRG stimulation to be at least sometimes effective. Neurosurgeons had mixed views on DBS, but most considered MCS to rarely be effective. Most clinicians thought that a randomised trial design could be successfully used to study neurostimulation therapies. Limitation There was a lack of robust research studies. Conclusions Currently available studies of the efficacy, effectiveness and safety of neurostimulation treatments do not provide robust, reliable results. Therefore, it is uncertain which treatments are best for chronic PLP. Future work Randomised crossover trials, randomised N-of-1 trials and prospective registry trials are viable study designs for future research. Study registration The study is registered as PROSPERO CRD42017065387. Funding The National Institute for Health Research Health Technology Assessment programme.

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“…Neuropathic pain in humans corresponds with increased activity of CMPf neurons (Hirato et al 1991). CMPf stimulation or ablation has been found to be helpful in the treatment of central pain and deafferentation pain (Hariz and Bergenheim 1995;Hollingworth et al 2017).…”

Section: The Peri-ventricular and Periaqueductal Graymentioning

confidence: 99%

Brain stimulation methods for pain treatment

Kvašňák

Rokyta²

2018

gpb

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Treatment of pain is one of the most important aims of medicine. Over the past several decades, invasive, semi-invasive and non-invasive brain stimulation methods have been tested and implemented for modulation of the pain. In this review, we bring an overview of those methods including stimulation of both deep brain structures utilizing invasive and semi-invasive techniques and the brain cortex stimulated by non-invasive transcranial magnetic and electrical techniques. Another potentially beneficial method that could modulate pain by stimulating the deep brain with interferential transcranial alternating current is discussed as well.

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Single Electrode Deep Brain Stimulation with Dual Targeting at Dual Frequency for the Treatment of Chronic Pain: A Case Series and Review of the Literature

Cited by 21 publications

References 44 publications

Imaging the Centromedian Thalamic Nucleus Using Quantitative Susceptibility Mapping

Imaging the Centromedian Thalamic Nucleus Using Quantitative Susceptibility Mapping

Brain and spinal stimulation therapies for phantom limb pain: a systematic review

Brain stimulation methods for pain treatment

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