Deep brain stimulation of the anterior cingulate cortex: targeting the affective component of chronic pain.

Abstract

Deep brain stimulation (DBS) has shown promise for relieving nociceptive and neuropathic symptoms of refractory chronic pain. We assessed the efficacy of a new target for the affective component of pain, the anterior cingulate cortex (ACC). A 49-year-old man with neuropathic pain underwent bilateral ACC DBS. Patient-reported outcome measures were collected before and 2 years after surgery using a Visual Analogue Scale, Short-Form 36 quality of life survey, McGill pain questionnaire, EuroQol-5D questionnaires (EQ-5D; Health State) and neuropsychological assessments. The patient improved with DBS. Two years after surgery, the Visual Analogue Scale decreased from 6.7 to 3.0, McGill pain questionnaire improved by 42% and EQ-5D Health State increased by 150%. Stimulating the ACC at 130 Hz, 330 µs and 3 V facilitated neuropathic pain relief. The DBS remained efficacious during the 2-year follow-up period. Affective ACC DBS can relieve chronic neuropathic pain refractory to pharmacotherapy and restore quality of life.

• Authors: Sandra G J Boccard, Erlick A C Pereira, Liz Moir, Tim J Van Hartevelt, Morten L Kringelbach, James J FitzGerald, Ian W Baker, Alexander L Green, Tipu Z Aziz
• Journal: Neuroreport (Neuroreport) Vol. 25 Issue 2 Pg. 83-8 (Jan 22 2014) ISSN: 1473-558X [Electronic] England
• PMID: 24100411 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Chronic Pain (therapy)
• Deep Brain Stimulation (methods)
• Gyrus Cinguli (physiology)
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Neuropsychological Tests
• Pain Measurement