Skip to main content

Neurostimulation: Stimulation of the Cranium and Head: Stimulation of the Deep Brain for the Treatment of Chronic Pain

  • Chapter
Atlas of Implantable Therapies for Pain Management

Abstract

Deep brain stimulation (DBS) is a therapy that has been used for more than half a century to treat chronic pain. The first use of these treatments occurred in the 1950s when neurosurgeons stimulated the septal region nuclei in patients with psychiatric diseases who also suffered from chronic pain. Over the next 20 years, the therapy evolved to include the sensory thalamic nuclei to treat pain of neuropathic origin. Stimulation of the periventricular grey matter (PVG) has generally been recommended for the treatment of nociceptive pain, whereas the sensory thalamus (ST) remains the preferred stimulation site for neuropathic pain. Currently several new targets are under investigation. Outcomes for both facial and extremity pain have been positive with appropriate patient and target selection. The use of DBS in the neuromodulation algorithm is increasingly helpful to those who have severe pain. Because of its invasiveness and the risks associated with DBS, it is restricted to a selected group of patients in whom conservative treatment of chronic pain syndromes has been ineffective.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Zrinzo L, Foltynie T, Limousin P, Hariz MI. Reducing hemorrhagic complications in functional neurosurgery: a large case series and systematic literature review. J Neurosurg. 2012;116:84–94.

    Article  PubMed  Google Scholar 

  2. Falowski S, Ooi YC, Smith A, Verhargen Metman L, Bakay RA. An evaluation of hardware and surgical complications with deep brain stimulation based on diagnosis and lead location. Stereotact Funct Neurosurg. 2012;90:173–80.

    Article  PubMed  Google Scholar 

  3. Baizabal Carvallo JF, Mostile G, Almaguer M, Davidson A, Simpson R, Jankovic J. Deep brain stimulation hardware complications in patients with movement disorders: risk factors and clinical correlations. Stereotact Funct Neurosurg. 2012;90:300–6.

    Article  PubMed  Google Scholar 

  4. Coley E, Farhadi R, Lewis S, Whittle IR. The incidence of seizures following deep brain stimulating electrode implantation for movement disorders, pain and psychiatric conditions. Br J Neurosurg. 2009;23:179–83.

    Article  CAS  PubMed  Google Scholar 

Suggested Reading

  • Abosch A, Timmermann L, Bartley S, Rietkerk HG, Whiting D, Connolly PJ, et al. An international survey of deep brain stimulation procedural steps. Stereotact Funct Neurosurg. 2013;91(1):1–11.

    Article  PubMed  Google Scholar 

  • Boccard SG, Pereira EA, Moir L, Aziz TZ, Green AL. Long-term outcomes of deep brain stimulation for neuropathic pain. Neurosurgery. 2013;72:221–30.

    Article  PubMed  Google Scholar 

  • Hosobuchi Y. Dorsal periaqueductal gray matter stimulation in humans. Pacing Clin Electrophysiol. 1987;10:213–6.

    Article  CAS  PubMed  Google Scholar 

  • Kumar K, Toth C, Nath RK. Deep brain stimulation for intractable pain: a 15-year experience. Neurosurgery. 1997;40:736–46.

    Article  CAS  PubMed  Google Scholar 

  • Kumar K, Wyant GM, Nath R. Deep brain stimulation for control of intractable pain in humans, present and future: a ten-year follow-up. Neurosurgery. 1990;26:774–82.

    Article  CAS  PubMed  Google Scholar 

  • Levy RM, Lamb S, Adams JE. Treatment of chronic pain by deep brain stimulation: long-term follow-up and review of the literature. Neurosurgery. 1987;21:885–93.

    Article  CAS  PubMed  Google Scholar 

  • Pool JL, Clark WD, Hudson P, Lombardo M. Hypothalamic-hypophyseal interrelationships. Springfield: Charles C. Thomas; 1956.

    Google Scholar 

  • Rinaldi PC, Young RF, Albe-Fessard D, Chodakiewitz J. Spontaneous neuronal hyperactivity in the medial and intralaminar thalamic nuclei of patients with deafferentation pain. J Neurosurg. 1991;74:415–21.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Timothy R. Deer MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media New York

About this chapter

Cite this chapter

Lad, S.P., Petersen, E.A., Marky, A., Deer, T.R., Levy, R.M. (2016). Neurostimulation: Stimulation of the Cranium and Head: Stimulation of the Deep Brain for the Treatment of Chronic Pain. In: Deer, T., Pope, J. (eds) Atlas of Implantable Therapies for Pain Management. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2110-2_32

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-2110-2_32

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2109-6

  • Online ISBN: 978-1-4939-2110-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics