title: Deep brain stimulation for chronic pain investigated with magnetoencephalography.
abstract: Deep brain stimulation has shown remarkable potential in alleviating otherwise treatment-resistant chronic pain, but little is currently known about the underlying neural mechanisms. Here for the first time, we used noninvasive neuroimaging by magnetoencephalography to map changes in neural activity induced by deep brain stimulation in a patient with severe phantom limb pain. When the stimulator was turned off, the patient reported significant increases in subjective pain. Corresponding significant changes in neural activity were found in a network including the mid-anterior orbitofrontal and subgenual cingulate cortices; these areas are known to be involved in pain relief. Hence, they could potentially serve as future surgical targets to relieve chronic pain.
authors.affiliation: Department of Physiology, Anatomy and Genetics, University of Oxford, and Nuffield Department of Surgery, John Radcliffe Hospital, Oxford, UK. morten.kringelbach@physiol.ox.ac.uk
authors.forename: Morten L
authors.initials: ML
authors.lastname: Kringelbach
authors.forename: Ned
authors.initials: N
authors.lastname: Jenkinson
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Green
authors.forename: Sarah L F
authors.initials: SL
authors.lastname: Owen
authors.forename: Peter C
authors.initials: PC
authors.lastname: Hansen
authors.forename: Piers L
authors.initials: PL
authors.lastname: Cornelissen
authors.forename: Ian E
authors.initials: IE
authors.lastname: Holliday
authors.forename: John
authors.initials: J
authors.lastname: Stein
authors.forename: Tipu Z
authors.initials: TZ
authors.lastname: Aziz
mesh_terms: D001921:Brain / Q000033:anatomy & histology / Q000503:physiopathology*; D001931:Brain Mapping; D002908:Chronic Disease; D046690:Deep Brain Stimulation / Q000379:methods*; D007839:Functional Laterality / Q000502:physiology; D006179:Gyrus Cinguli / Q000033:anatomy & histology / Q000503:physiopathology; D006801:Humans; D015225:Magnetoencephalography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000503:physiopathology*; D010148:Intractable Pain / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D010591:Phantom Limb / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D011237:Predictive Value of Tests; D017397:Prefrontal Cortex / Q000033:anatomy & histology / Q000503:physiopathology; D016896:Treatment Outcome