Deep brain stimulation for the treatment of chronic, intractable pain.
Deep brain stimulation (DBS) was first used for the treatment of pain in 1954. Since that time, remarkable advances have been made in the field of DBS, largely because of the resurgence of DBS for the treatment of movement disorders. Although DBS for pain has largely been supplanted by motor cortex and spinal cord stimulation during the last decade, no solid evidence exists that these alternative modalities truly offer improved outcomes. Furthermore, nuclei not yet fully explored are known to play a role in the transmission and modulation of pain. This article outlines the history of DBS for pain, pain classification, patient selection criteria, DBS target selection, surgical techniques, indications for DBS (versus ablative techniques), putative new DBS targets, complications, and the outcomes associated with DBS for pain.
Wallace
Bradley A
BA
Department of Neurosurgery, University of Florida, Gainesville 32610, USA. wallace@neurosurgery.ufl.edu
Ashkan
Keyoumars
K
Benabid
Alim-Louis
AL
D001921:Brain / Q000503:physiopathology*; D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D010148:Intractable Pain / Q000503:physiopathology / Q000628:therapy*; D013238:Stereotaxic Techniques