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.
No comments:
Post a Comment