Deep brain stimulation for chronic pain.
J Clin Neurosci
; 22(10): 1537-43, 2015 Oct.
Article
em En
| MEDLINE
| ID: mdl-26122383
ABSTRACT
Deep brain stimulation (DBS) is a neurosurgical intervention popularised in movement disorders such as Parkinson's disease, and also reported to improve symptoms of epilepsy, Tourette's syndrome, obsessive compulsive disorders and cluster headache. Since the 1950s, DBS has been used as a treatment to relieve intractable pain of several aetiologies including post stroke pain, phantom limb pain, facial pain and brachial plexus avulsion. Several patient series have shown benefits in stimulating various brain areas, including the sensory thalamus (ventral posterior lateral and medial), the periaqueductal and periventricular grey, or, more recently, the anterior cingulate cortex. However, this technique remains "off label" in the USA as it does not have Federal Drug Administration approval. Consequently, only a small number of surgeons report DBS for pain using current technology and techniques and few regions approve it. Randomised, blinded and controlled clinical trials that may use novel trial methodologies are desirable to evaluate the efficacy of DBS in patients who are refractory to other therapies. New imaging techniques, including tractography, may help optimise electrode placement and clinical outcome.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dor Intratável
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Estimulação Encefálica Profunda
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Dor Crônica
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Analgesia
Tipo de estudo:
Clinical_trials
Limite:
Adult
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Humans
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article