Navigation Links
For some, deep brain stimulation brings lasting improvement in neuropathic pain
Date:2/13/2013

Philadelphia, Pa. (February 13, 2013) For many patients with difficult-to-treat neuropathic pain, deep brain stimulation (DBS) can lead to long-term improvement in pain scores and other outcomes, according to a study in the February issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

About two-thirds of eligible patients who undergo DBS achieve significant and lasting benefits in terms of pain, quality of life, and overall health, according to the report by Sandra G.J. Boccard, PhD, and colleagues of University of Oxford, led by Tipu Aziz FMedSci and Alex Green, MD. Some outcomes show continued improvement after the first year, according to the new report, which is one of the largest studies of DBS for neuropathic pain performed to date.

Most Patients Benefit from DBS for Neuropathic Pain

The authors reviewed their 12-year experience with DBS for neuropathic pain. Neuropathic pain is a common and difficult-to-treat type of pain caused by nerve damage, seen in patients with trauma, diabetes, and other conditions. Phantom limb pain after amputation is an example of neuropathic pain.

In DBS, a small electrode is surgically placed in a precise location in the brain. A mild electrical current is delivered to stimulate that area of the brain, with the goal of interrupting abnormal activity. Deep brain stimulation has become a standard and effective treatment for movement disorders such as Parkinson's disease. Although DBS has also been used to treat various types of chronic pain, its role in patients with neuropathic pain remains unclear.

Between 1999 and 2011, that authors' program evaluated 197 patients with chronic neuropathic pain for eligibility for DBS. Of these, 85 patients proceeded to DBS treatment. The remaining patients did not receive DBSmost commonly because they were unable to secure funding from the U.K. National Health Service or decided not to undergo electrode placement surgery.

The patients who underwent DBS were 60 men and 25 women, average age 52 years. Stroke was the most common cause of neuropathic pain, followed by head and face pain, spinal disease, amputation, and injury to nerves from the upper spinal cord (brachial plexus).

In 74 patients, a trial of DBS produced sufficient pain relief to proceed with implantation of an electrical pulse generator. Of 59 patients with sufficient follow-up data, 39 had significant improvement in their overall health status up to four years later. Thus, 66 percent of patients "gained benefit and efficacy" by undergoing DBS.

Benefits Vary by Cause; Some Outcomes Improve with Time

The benefits of DBS varied for patients with different causes of neuropathic pain. Treatment was beneficial for 89 percent for patients with amputation and 70 percent of those with stroke, compared to 50 percent of those with brachial plexus injury.

On average, scores on a 10-point pain scale (with 10 indicating the most severe pain) decreased from about 8 to 4 within the first three months, remaining about the same with longer follow-up. Continued follow-up in a small number of patients suggested further improvement in other outcomes, including quality-of-life scores.

Deep brain stimulation has long been regarded as potentially useful for patients with severe neuropathic pain that is not relieved by other treatments. However, because of the difficulties of performing studies of this highly specialized treatment, there has been relatively little research to confirm its benefits; only about 1,500 patients have been treated worldwide. The new studyaccounting for about five percent of all reported patientsused up-to-date DBS technologies, imaging, and surgical techniques.

Dr. Boccard and coauthors acknowledge some important limitations of their studyespecially the lack of complete patient follow-up. However, they believe their experience is sufficiently encouraging to warrant additional studies, especially with continued advances in stimulation approaches and technology. The researchers conclude, "Clinical trials retaining patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series."


'/>"/>
Contact: Connie Hughes
connie.hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

Related medicine news :

1. For Some, Views on Global Warming Change With the Weather
2. Diets High in Fructose May Harm Liver in Some, Scientists Warn
3. For Some, Glaucoma Strikes at a Young Age
4. In some dystonia cases, deep brain therapy benefits may linger after device turned off
5. DAI provides potential imaging biomarker to indicate brain tumor response to RT
6. Imaging acute ischemic stroke patients brains did not lead to improved outcomes
7. New brain-test app
8. Dickkopf makes fountain of youth in the brain run dry
9. No increase in brain aneurysm rupture risk during pregnancy and delivery
10. Veterans with mild traumatic brain injury have brain abnormalities
11. Electrical Brain Stimulation Plus Drug Fights Depression: Study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/11/2016)... Island, NY (PRWEB) , ... February 11, 2016 ... ... has enhanced and updated its hallmark resource, Infusion Therapy Standards of Practice, to ... leader in vein illumination with an estimated 85% share of the market, facilitates ...
(Date:2/11/2016)... ... February 11, 2016 , ... The annual list showcases the 20 Most Promising ... team dedication and commitment to the SharePoint ecosystem. A panel of experts and ... goal is to recognize and promote technology entrepreneurship. , The survey was made ...
(Date:2/11/2016)... , ... February 11, 2016 , ... ... dynamometers and ergoFET force gauges used in physical therapy, occupational therapy and sports ... sensor for resistance cord exercise and therapy, introduces its new microFET Digital Pinch ...
(Date:2/11/2016)... (PRWEB) , ... February 11, 2016 , ... ... coverage results in significantly higher rates of several common cancer screenings, especially among ... in better outcomes and survival rates. , The study,“What Does Medicaid Expansion ...
(Date:2/10/2016)... ... February 10, 2016 , ... Sherly Sulaiman, certified clinical ... of therapeutic sessions to help Los Angeles-area actors cope with rejection, improve their ... series, known as “Mindfulness for Actors and Artists,” has been featured in ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... Fla. , Feb. 11, 2016 PLAD, ... started out 2016 with sales exceeding company targets, are ... have received their trademark from the United States Patent ... Bobby Clark , Chief Executive Officer of PLAD, Inc.  ... of Pennsylvania with two new ...
(Date:2/11/2016)... Feb. 11, 2016  Delcath Systems, Inc. (NASDAQ: ... device company focused on oncology with an emphasis ... cancers, announces the engagement of Lars E. ... Medical Consultant. Dr. Birgerson will provide strategic medical ... operations team to help ensure timely facilitation of ...
(Date:2/11/2016)... ENGLEWOOD, Colo. , Feb. 11, 2016  Aytu ... on developing treatments for urological and related conditions, announced ... for the second fiscal quarter of 2016 on Tuesday, ... will review recent accomplishments and provide an overview of ... financial results for the quarter ended December 31, 2015. ...
Breaking Medicine Technology: