What Is Deep Brain Stimulation And When Might It Be Considered To Treat Pain?

— -- Question: What Is Deep Brain Stimulation And When Is It Used To Treat Pain?

Answer: Yeah, deep brain stimulation, again, is a technique that's been evolving over the last few decades.

It's a technique where a surgeon will use a set of coordinates to try to map out a special area of the brain; an area where pain impulses may project from the periphery all the way up into the brain. And usually these are in and around the thalamus. These targets then can have an electrode actually passed in through the brain tissue, into this area, and then stimulate it electrically.

This can be very effective in some syndromes. For instance, phantom pain syndrome has been one that seems to respond well to this. Other times, post-stroke pain, or post-spinal-cord-injury pain can respond to it. But I think in general, most of the surgeons that are doing these techniques nowadays are somewhat disappointed by the results. And what we've gone to instead for many of these syndromes is to try a technique that does not penetrate the brain called motor cortex stimulation.

The motor cortex can be targeted external to the brain substance. And it involves just making a small window in the skull in order to place again an electrode, and stimulate that motor cortex. And by doing this, we're able to treat many conditions such as severe facial pain quite effectively. And I think it's really much more satisfactory to do this, as at least a first-line agent. And then if that doesn't work, then one could consider something like deep brain stimulation depending on what they were treating.

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