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Deep brain stimulation is valuable to reduce neuropathic dental pain

Deep brain stimulation is valuable to reduce neuropathic dental pain Deep brain stimulation is valuable to reduce neuropathic dental pain
Deep brain stimulation is valuable to reduce neuropathic dental pain Deep brain stimulation is valuable to reduce neuropathic dental pain

A study was carried to explore optimal thalamic target to alleviate neuropathic dental pain with the help of the steering abilities of a directional deep brain stimulation electrode.

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Key take away

Ventral posterior medial (VPM) stimulation in combination with centromedian (CM) stimulation was found to be a promising target for neuropathic dental pain. 

Background

A study was carried to explore optimal thalamic target to alleviate neuropathic dental pain with the help of the steering abilities of a directional deep brain stimulation electrode.

Method

Review and literature search of the database detected three potential thalamic targets. Implantation of the directional lead was done in a patient having neuropathic dental pain. Its current steering was utilized to determine the effects in each nucleus.

The pain was reported by the patient after two weeks of stimulation in a randomized prospective blinded study. Estimation of quality of life was carried out before and after three months. 

Result

Three potential nuclei were detected: (i) CM, (ii) VPM, and (iii) anterior pulvinar. The best results were witnessed during CM stimulation (50% decline) and VPM stimulation (>90% decline in pain).


After three months of the VPM-deep brain stimulation in combo with lateral CM stimulation, the pain disability was found to decrease from 25 to 0 while the short form 36 improved from 67.5 to 90. Deep brain stimulation electrode directionality can be utilized for testing multiple targets and selecting a patient-specific "sweet spot" to alleviate dental pain.

Conclusion

Directional deep brain stimulation can target the thalamic optimal target and minimize neuropathic dental pain.

Source:

Operative Neurosurgery

Article:

Directional Deep Brain Stimulation Can Target the Thalamic "Sweet Spot" for Improving Neuropathic Dental Pain

Authors:

Marie T Krüger et al.

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