Neurostimulation: Stimulation of the Cranium and Head: Stimulation of the Deep Brain for the Treatment of Chronic Pain
Deep brain stimulation (DBS) is a therapy that has been used for more than half a century to treat chronic pain. The first use of these treatments occurred in the 1950s when neurosurgeons stimulated the septal region nuclei in patients with psychiatric diseases who also suffered from chronic pain. Over the next 20 years, the therapy evolved to include the sensory thalamic nuclei to treat pain of neuropathic origin. Stimulation of the periventricular grey matter (PVG) has generally been recommended for the treatment of nociceptive pain, whereas the sensory thalamus (ST) remains the preferred stimulation site for neuropathic pain. Currently several new targets are under investigation. Outcomes for both facial and extremity pain have been positive with appropriate patient and target selection. The use of DBS in the neuromodulation algorithm is increasingly helpful to those who have severe pain. Because of its invasiveness and the risks associated with DBS, it is restricted to a selected group of patients in whom conservative treatment of chronic pain syndromes has been ineffective.
