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Deep brain stimulation of the anterior cingulate cortex: targeting the affective component of chronic pain

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  • Sandra G J Boccard
  • ,
  • Erlick A C Pereira
  • ,
  • Liz Moir
  • ,
  • Tim J Van Hartevelt, Denmark
  • Morten L. Kringelbach
  • James J Fitzgerald
  • ,
  • Ian W Baker
  • ,
  • Alexander L Green
  • ,
  • Tipu Z Aziz
Deep brain stimulation (DBS) has shown promise for relieving nociceptive and neuropathic symptoms of refractory chronic pain. We assessed the efficacy of a new target for the affective component of pain, the anterior cingulate cortex (ACC). A 49-year-old man with neuropathic pain underwent bilateral ACC DBS. Patient-reported outcome measures were collected before and 2 years after surgery using a Visual Analogue Scale, Short-Form 36 quality of life survey, McGill pain questionnaire, EuroQol-5D questionnaires (EQ-5D; Health State) and neuropsychological assessments. The patient improved with DBS. Two years after surgery, the Visual Analogue Scale decreased from 6.7 to 3.0, McGill pain questionnaire improved by 42% and EQ-5D Health State increased by 150%. Stimulating the ACC at 130 Hz, 330 µs and 3 V facilitated neuropathic pain relief. The DBS remained efficacious during the 2-year follow-up period. Affective ACC DBS can relieve chronic neuropathic pain refractory to pharmacotherapy and restore quality of life.
Original languageEnglish
Pages (from-to)83-88
Publication statusPublished - 22 Jan 2014

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