Deep Brain Stimulation of the Central Lateral and Ventral Posterior Thalamus for Central Poststroke Pain Syndrome: Preliminary Experience.

Nowacki, Andreas; Zhang, David; Barlatey, Sabry; Ai-Schläppi, Janine; Rosner, Jan; Arnold, Marcel; Pollo, Claudio (2023). Deep Brain Stimulation of the Central Lateral and Ventral Posterior Thalamus for Central Poststroke Pain Syndrome: Preliminary Experience. Neuromodulation, 26(8), pp. 1747-1756. Wiley 10.1016/j.neurom.2022.09.005

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OBJECTIVE

The beneficial effects of thalamic deep brain stimulation (DBS) at various target sites in treating chronic central neuropathic pain (CPSP) remain unclear. This study aimed to evaluate the effectiveness of DBS at a previously untested target site in the central lateral (CL) thalamus, together with classical sensory thalamic stimulation (ventral posterior [VP] complex).

MATERIALS AND METHODS

We performed a monocentric retrospective study of a consecutive series of six patients with CPSP who underwent combined DBS lead implantation of the CL and VP. Patient-reported outcome measures were recorded before and after surgery using the numeric rating scale (NRS), short-form McGill pain questionnaire (sf-MPQ), EuroQol 5-D quality-of-life questionnaire, and Beck Depression Inventory. DBS leads were reconstructed and projected onto a three-dimensional stereotactic atlas.

RESULTS

NRS-but not sf-MPQ-rated pain intensity-was significantly reduced throughout the follow-up period of 12 months compared with baseline (p = 0.005, and p = 0.06 respectively, Friedman test). At the last available follow-up (12 to 30 months), three patients described a more than 50% reduction. Two of the three long-term responders were stimulated in the CL (1000 Hz, 90 μs, 3.5-5.0 mA), whereas the third preferred VP complex stimulation (50 Hz, 200 μs, 0.7-1.2 mA). No persistent procedure- or stimulation-associated side effects were noted.

CONCLUSIONS

These preliminary findings suggest that DBS of the CL might constitute a promising alternative target in cases in which classical VP complex stimulation does not yield satisfactory postoperative pain reduction. The results need to be confirmed in larger, prospective series of patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Nowacki, Andreas, Zhang, David Yuzhe, Barlatey, Sabry, Schläppi, Janine Ai, Rosner, Jan, Arnold, Marcel, Pollo, Claudio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1525-1403

Publisher:

Wiley

Language:

English

Submitter:

Pubmed Import

Date Deposited:

24 Oct 2022 14:31

Last Modified:

09 Dec 2023 00:11

Publisher DOI:

10.1016/j.neurom.2022.09.005

PubMed ID:

36266180

Uncontrolled Keywords:

Central lateral thalamus central poststroke pain syndrome deep brain stimulation

BORIS DOI:

10.48350/174011

URI:

https://boris.unibe.ch/id/eprint/174011

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