Deep brain stimulation for the control of pain

Ira Garonzik, Amer Samdani, Shingi Ohara, Frederick A. Lenz

Research output: Contribution to journalArticlepeer-review

Abstract

The most common sites of deep brain stimulation (DBS) for relief of pain are the periaqueductal gray (PAG) for nociceptive pain and the principal sensory nucleus of the thalamus (Vc) for control of neuropathic pain. The mechanism of action of PAG stimulation seems to involve release of endogenous opiates, whereas the mechanism of Vc stimulation may involve either antidromic activation of the spinothalamic tract or orthodromic activation of thalamocortical relay cells. Success rates are higher for PAG stimulation than for Vc stimulation, but long-term success rates for both are in the range 40 to 60%. The rate of complications with DBS is lower in recent literature of DBS for movement disorders than in earlier literature of DBS for pain, suggesting that hardware modifications have decreased the rate of complications. DBS is an option in patients with chronic pain who are refractory to other modes of medical and surgical therapy.

Original languageEnglish (US)
Pages (from-to)S55-S60
JournalEpilepsy and Behavior
Volume2
Issue number3 SUPPL. 3
DOIs
StatePublished - Jan 1 2001

Keywords

  • Deep brain stimulation
  • Pain
  • Periaqueductal gray
  • Thalamus

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

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