Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Saturday, April 8, 2017

Randomized clinical trial of deep brain stimulation for post-stroke pain

Hopefully your doctor becomes aware of this solution.
https://www.mdlinx.com/internal-medicine/medical-news-article/2017/04/06/post-stroke-pain-deep-brain-stimulation/7124427/?
Annals of Neurology
Lempka SF, et al.
The researchers aimed to test the hypothesis that targeting limbic neural pathways would modulate the affective sphere of pain and alleviate suffering. In chronic pain management, ventral striatum/anterior limb of the internal capsule (VS/ALIC) deep brain stimulation (DBS) to modulate the affective sphere of pain represents a paradigm shift. VS/ALIC DBS revealed an acceptable safety profile and statistically–significant improvements in multiple outcome measures related to the affective sphere of pain while this exploratory study was negative for its initial endpoint. They, therefore, believe these outcomes justify further work in neuromodulation therapies targeting the affective sphere of pain.

Methods

  • A prospective, double-blinded, randomized, placebo-controlled, crossover study of DBS targeting the ventral striatum/anterior limb of the internal capsule (VS/ALIC) in 10 patients with post-stroke pain syndrome was conducted.
  • 1 month after bilateral DBS, they randomized patients to active DBS or sham for 3 months, followed by cross-over for another 3-month period.
  • The initial endpoint was a ≥ 50% improvement in the Pain Disability Index in 50% of patients with active DBS compared to sham.
  • This 6-month blinded phase was followed by an 18-month open-stimulation phase.

Results

  • In this study, 9 participants completed randomization.
  • The researchers did observe significant differences in multiple outcome measures related to the affective sphere of pain (e.g. Montgomery-Asberg Depression Rating Scale, Beck Depression Inventory, Affective Pain Rating Index of the Short-form McGill Pain Questionnaire) although this trial was negative for its primary and secondary endpoints.
  • They recorded and resolved 14 serious adverse events.

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