Sustained reduction of hypertension by deep brain stimulation.
Deep brain stimulators were implanted in the left periaqueductal gray matter (PAG) and sensory thalamus for right sided neuropathic facial pain refractory to other treatments in a man aged 58 years. PAG stimulation 8 months later acutely reduced systolic blood pressure by 25 mm Hg during revision surgery. One year post procedure, ambulatory blood pressure monitoring demonstrated significant and sustained reduction in blood pressure with PAG stimulation. Mean systolic blood pressure decreased by 12.6mm Hg and diastolic by 11.0mm Hg, alongside reductions in variability of heart rate and pulse pressure. This neurosurgical treatment may prove beneficial for medically refractory hypertension.
Pereira
Erlick A C
EA
Nuffield Department of Surgery, University of Oxford, Oxford, UK. eacp@eacp.co.uk
Wang
Shouyan
S
Paterson
David J
DJ
Stein
John F
JF
Aziz
Tipu Z
TZ
Green
Alexander L
AL
D001341:Autonomic Nervous System / Q000502:physiology / Q000601:surgery*; D017776:Autonomic Pathways / Q000503:physiopathology / Q000601:surgery; D001794:Blood Pressure / Q000502:physiology*; D002908:Chronic Disease / Q000628:therapy; D046690:Deep Brain Stimulation / Q000379:methods*; D004567:Electrodes, Implanted; D005157:Facial Pain / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010487:Periaqueductal Gray / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*; D013788:Thalamus / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D016896:Treatment Outcome