Skip to main content
SpringerLink
Log in

Deep Brain Stimulation for Chronic Pain

  • Anesthetic Techniques in Pain Management (D Wang, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Deep brain stimulation (DBS) is a commonly performed procedure and has been used for the treatment of chronic pain since the early 1970s. A review of the literature was performed utilizing the PubMed database evaluating the use of DBS in the treatment of various pain syndromes. Literature over the last 30 years was included with a focus on those articles in the last 10 years dealing with pain conditions with the highest success as well as the targets utilized for treatment. DBS carries favorable results for the treatment of chronic pain, especially when other methods have not been successful such as medications, conservative measures, and extracranial procedures. Various chronic pain conditions reported in the literature respond to DBS including failed back surgery syndrome (FBSS), phantom limb pain, and peripheral neuropathic pain with a higher response rate for those with nociceptive pain compared to neuropathic pain. Cephaligias have promising results, with cluster headaches carrying the best success rates. DBS plays a role in the treatment of chronic pain conditions. Although considered investigational in the USA, it carries promising success rates in a recalcitrant patient population.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Hamani C, Schwalb JM, Rezai AR, et al. Deep brain stimulation for chronic neuropathic pain: long-term outcome and the incidence of insertional effect. Pain. 2006;125(1–2):188–96.

    Article  PubMed  Google Scholar 

  2. Bittar RG, Kar-Purkayastha I, Owen SL, Bear RE, Green A, Wang S, et al. Deep brain stimulation for pain relief: a meta-analysis. J Clin Neurosci. 2005;12(5):515–9.

    Article  PubMed  Google Scholar 

  3. 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 

  4. 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 

  5. Turnbull IM, Shulman R, Woodhurst WB. Thalamic stimulation for neuropathic pain. J Neurosurg. 1980;52:486–93.

    Article  CAS  PubMed  Google Scholar 

  6. Levy RM, Deer T, Henderson J. Intracranial neurostimulation for pain control: a review. Pain Physician. 2010;13:157–65. This is a thorough review of various indications and results for DBS in the treatment of chronic pain as well as an evaluation of the procedure. It also looks at other treatment modalities of the Intracranial space including Motor Cortex Stimulation.

    PubMed  Google Scholar 

  7. Parmar VK, Gee L, Smith H, Pilitsis JG. Supraspinal stimulation for the treatment of refractory pain. Clin Neurol Neurosurg. 2014;123:155–63.

    Article  CAS  PubMed  Google Scholar 

  8. Bittar RG, Otero S, Carter H, Aziz TZ. Deep brain stimulation for phantom limb pain. J Clin Neurosci. 2005;12(4):399–404.

    Article  PubMed  Google Scholar 

  9. Owen SL, Green AL, Nandi DD, Bittar RG, Wang S, Aziz TZ. Deep brain stimulation for neuropathic pain. Acta Neurochir Suppl. 2007;97(Pt 2):111–6.

    CAS  PubMed  Google Scholar 

  10. Green AL, Nandi D, Armstrong G, Carter H, Aziz T. Post-herpetic trigeminal neuralgia treated with deep brain stimulation. J Clin Neurosci. 2003;10(4):512–4.

    Article  CAS  PubMed  Google Scholar 

  11. Leone M, May A, Franzini A, et al. Deep brain stimulation for intractable chronic cluster headache: proposals for patient selection. Cephalalgia. 2004;24(11):934–7.

    Article  CAS  PubMed  Google Scholar 

  12. Leone M, Franzini A, Broggi G, Bussone G. Hypothalamic deep brain stimulation for intractable chronic cluster headache: a 3-year follow-up. Neurol Sci. 2003;24:S143–5.

    PubMed  Google Scholar 

  13. Jenkins B, Tepper S. Neurostimulation for primary headache disorders: part 2, review of central neurostimulators for primary headache, overall therapeutic efficacy, safety, cost, patient selection, and future research in headache neuromodulation. Headache. 2011;51:1408–18.

    Article  PubMed  Google Scholar 

  14. Chodakiewitz Y, Bicalho G, Chodakiewitz J. Multi-target neurostimulation for adequate long term relief of neuropathic and nociceptive chronic pain components. Surg Neurol Int. 2013;4:170–5.

    Article  Google Scholar 

  15. Gray A, Pounds-Cornish E, Eccles F, Aziz T, Green A, Scott R. Deep brain stimulation as a treatment for neuropathic pain: a longitudinal study addressing neuropsychological outcomes. J Pain. 2014;15(3):283–92.

    Article  PubMed  Google Scholar 

  16. Voges J, Waerzeggers Y, Maarouf M, et al. Deep-brain stimulation: long-term analysis of complications caused by hardware and surgery- experiences from a single centre. J Neurol Neurosurg Psychiatry. 2006;77:868–72.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Beric A, Kelly PJ, Rezai A, et al. Complications of deep brain stimulation surgery. Stereotact Funct Neurosurg. 2001;77:73–8.

    Article  CAS  PubMed  Google Scholar 

  18. Falowski S, Cher-Ooi Y, Smith A, Verhargen L, Bakay R. An evaluation of hardware and surgical complications with deep brain stimulation based on diagnosis and lead location. Stereotact Funct Neurosurg. 2012;90:173–80. This is an evaluation of the surgical and hardware complications with a review on surgical technique and technical nuances to decrease the risk of adverse events.

    Article  PubMed  Google Scholar 

  19. Deer T, Mekhail N, Peterson E, Krames E, Staats P, Pope J, et al. The appropriate use of neurostimulation: stimulation of the intracranial and extracranial space and head for chronic pain. Neuromodulation. 2014;17:551–70. Guidelines that have been released by the Neuromodulation Appropriate Consensus Committee (NACC) on all areas of Neuromodulation.

    Article  PubMed  Google Scholar 

  20. 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 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Steven M. Falowski declares no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

Author information

Authors and Affiliations

  1. St. Luke’s University Health Network, Bethlehem, PA, USA

    Steven M. Falowski

Authors
  1. Steven M. Falowski
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steven M. Falowski.

Additional information

This article is part of the Topical Collection on Anesthetic Techniques in Pain Management

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Falowski, S.M. Deep Brain Stimulation for Chronic Pain. Curr Pain Headache Rep 19, 27 (2015). https://doi.org/10.1007/s11916-015-0504-1

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11916-015-0504-1

Keywords

Search

Navigation