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Long-term results of Deep Brain Stimulation of the Anterior Cingulate Cortex for Neuropathic Pain.

Boccard, SG; Prangnell, SJ; Pycroft, L; Cheeran, B; Moir, L; Pereira, EAC; Fitzgerald, JJ; Green, AL; Aziz, TZ (2017) Long-term results of Deep Brain Stimulation of the Anterior Cingulate Cortex for Neuropathic Pain. World Neurosurg, 106. pp. 625-637. ISSN 1878-8769
SGUL Authors: Pereira, Erlick Abilio Coelho

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BACKGROUND: Deep Brain Stimulation of the Anterior Cingulate Cortex is a recent technique that has shown some promising short-term results in patients with chronic refractory neuropathic pain. Three years after the first case-series, we assessed its efficacy on a larger cohort, with longer follow-up. METHODS: 24 patients (19 males; 49.1 years) with neuropathic pain underwent bilateral ACC DBS. Patient reported outcome measures were collected pre- and post-surgery, using the Numerical Rating Scale (NRS), Short-Form 36 quality of life (SF-36), McGill pain (MPQ) and EuroQol-5D questionnaires. RESULTS: 22 patients after a trial week were fully internalized and 12 had a mean follow-up of 38.9 months. Six months post-surgery the mean NRS score dropped from 8.0 to 4.27 (P=.004). There was a significant improvement in the MPQ (mean -36%; P=.021) and EQ-5D score significantly decreased (mean -21%; P=.036). The PF domain of SF-36 was significantly improved (mean +54.2%; P=.01). Furthermore, in 83% of these patients: at 6 months NRS was improved by 60% (P<.001) and MPQ decreased by 47% (P<.01). After 1 year, NRS decreased by 43% (P< .01), EQ-5D was significantly reduced (mean -30.8; P=.05) and significant improvements were also observed for different domains of the SF-36. At longer follow-ups, efficacy was sustained up to 42 months in some patients, with a NRS as low as 3. CONCLUSIONS: Follow-up results confirm that ACC DBS alleviates chronic neuropathic pain refractory to pharmacotherapy and improves quality of life in a significant number of patients.

Item Type: Article
Additional Information: © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Keywords: Anterior Cingulate Cortex, Deep Brain Stimulation, Neuropathic pain
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: World Neurosurg
ISSN: 1878-8769
Language: eng
October 2017Published
11 July 2017Published Online
30 June 2017Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Project IDFunderFunder ID
UNSPECIFIEDEngineering and Physical Sciences Research Council
UNSPECIFIEDNational Institute for Health Research
PubMed ID: 28710048
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