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Brain Sciences
Volume 7
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10.3390/brainsci7010009
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Review

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

by
Milo Hollingworth
1,
Hugh P. Sims-Williams
2,
Anthony E. Pickering
3,
Neil Barua
1 and
Nikunj K. Patel
1,*
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.
Brain Sci. 2017, 7(1), 9; https://doi.org/10.3390/brainsci7010009
Submission 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)
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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.
Keywords: deep brain stimulation; CMPf; PAG/PVG; pain; pain pathways deep brain stimulation; CMPf; PAG/PVG; pain; pain pathways

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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. https://doi.org/10.3390/brainsci7010009

AMA Style

Hollingworth M, Sims-Williams HP, Pickering AE, Barua N, Patel NK. 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 Sciences. 2017; 7(1):9. https://doi.org/10.3390/brainsci7010009

Chicago/Turabian Style

Hollingworth, Milo, Hugh P. Sims-Williams, Anthony E. Pickering, Neil Barua, and Nikunj K. Patel. 2017. "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 Sciences 7, no. 1: 9. https://doi.org/10.3390/brainsci7010009

APA Style

Hollingworth, M., Sims-Williams, H. P., Pickering, A. E., Barua, N., & Patel, N. K. (2017). 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 Sciences, 7(1), 9. https://doi.org/10.3390/brainsci7010009

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