Deep Brain Stimulation for Chronic Pain Intracranial Targets, Clinical Outcomes, and Trial Design Considerations

作者：Keifer Orion Paul Jr; Riley Jonathan P; Boulis Nicholas M^*

来源：Neurosurgery Clinics of North America, 2014, 25(4): 671-+.

DOI：10.1016/j.nec.2014.07.009

• Deep brain stimulation
• Surgery
• Chronic pain
• Clinical trial design
• Sensory thalamus
• Intracranial stimulation
• Anterior cingulate cortex
• Periyentricular and periaqueductal gray

For over half a century, neurosurgeons have attempted to treat pain from a diversity of causes using acute and chronic intracranial stimulation. Targets of stimulation have included the sensory thalamus, periventricular and periaqueductal gray, the septum, the internal capsule, the motor cortex, posterior hypothalamus, and more recently, the anterior cingulate cortex. The current work focuses on presenting and evaluating the evidence for the efficacy of these targets in a historical context while also highlighting the major challenges to having a double-blind placebo-controlled clinical trial. Considerations for pain research in general and use of intracranial targets specifically are included.

• 出版日期2014-10