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Regional cerebral blood flow changes were evaluated in different subcortical brain targets following deep brain stimulation (DBS) for chronic pain. Three patients with intractable neuropathic pain were assessed; one had stimulating electrodes in the ventroposterolateral thalamic nucleus (VPL), one in the periventricular grey (PVG) area, and one had electrodes in both targets. Pain relief was achieved in all patients. Cerebral perfusion was measured by single-photon emission computed tomography to determine the effects of DBS. Comparison was made between individual scans using subtraction analysis. DBS consistently increased perfusion in the posterior subcortical region between VPL and PVG, regardless of the site of stimulation. Furthermore, thalamic and dual target DBS increased thalamic perfusion, yet PVG DBS decreased perfusion in the PVG-containing midbrain region and thalamus. Dual target stimulation decreased anterior cingulate and insular cortex perfusion. The study demonstrates regional differences in cerebral perfusion between three accepted and efficacious targets for analgesic DBS.

Original publication

DOI

10.1159/000101296

Type

Journal article

Journal

Stereotact Funct Neurosurg

Publication Date

2007

Volume

85

Pages

175 - 183

Keywords

Central Nervous System Diseases, Chronic Disease, Deep Brain Stimulation, Electrophysiology, Female, Humans, Magnetoencephalography, Male, Middle Aged, Midline Thalamic Nuclei, Pain, Pain Management, Regional Blood Flow, Tomography, Emission-Computed, Single-Photon, Treatment Outcome, Ventral Thalamic Nuclei