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Brain Sci. 2017, 7(1), 9; doi:10.3390/brainsci7010009

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

1
Department of Neurosurgery, North Bristol Trust, Bristol BS10 5NB, UK
2
Department of Neurosurgery, Sheffield Teaching Hospital, Sheffield S10 2JF, UK
3
School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol BS8 1TD, UK
*
Author to whom correspondence should be addressed.
Academic Editors: Tipu Aziz and Alex Green
Received: 9 November 2016 / Revised: 4 January 2017 / Accepted: 9 January 2017 / Published: 13 January 2017
(This article belongs to the Special Issue Deep Brain Stimulation (DBS) Applications)
View Full-Text   |   Download PDF [642 KB, uploaded 13 January 2017]   |  

Abstract

Deep Brain Stimulation (DBS) has been used to target many deep brain structures for the treatment of chronic pain. The periaqueductal grey and periventricular grey (PAG/PVG) is an effective target but results are variable, sometimes short-lived or subject to tolerance. The centromedian intra-laminar parafascicular complex (CMPf) modulates medial pain pathways and CMPf DBS may address the affective aspects of pain perception. Stimulation of multiple deep brain targets may offer a strategy to optimize management of patients with complex pain symptomatology. However, previous attempts to stimulate multiple targets requires multiple trajectories and considerable expense. Using a single electrode to stimulate multiple targets would help overcome these challenges. A pre-requisite of such a technique is the ability to use different stimulation parameters at different contacts simultaneously on the same electrode. We describe a novel technique in 3 patients with chronic pain syndromes for whom conventional medical and/or neuromodulation therapy had failed using a single electrode technique to stimulate PVG/PAG and CMPf at dual frequencies. View Full-Text
Keywords: deep brain stimulation; CMPf; PAG/PVG; pain; pain pathways deep brain stimulation; CMPf; PAG/PVG; pain; pain pathways
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Hollingworth, M.; Sims-Williams, H.P.; Pickering, A.E.; Barua, N.; Patel, N.K. 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. Brain Sci. 2017, 7, 9.

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