Deep Brain Stimulation as a Treatment for Neuropathic Pain: A Longitudinal Study Addressing Neuropsychological Outcomes |
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| Affiliation: | 1. Headwise Ltd, Birmingham, England, United Kingdom;2. Clinical Psychology Unit, University of Sheffield, Sheffield, England, United Kingdom;3. National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, Buckinghamshire, England;4. Division of Health Research, Lancaster University, Lancaster, England, United Kingdom;6. Oxford Functional Neurosurgery and Experimental Neurology, John Radcliffe Hospital, Oxford, England, United Kingdom;1. Stanford Neurosurgical Artificial Intelligence and Machine Learning Laboratory, Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA;2. Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland;3. Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland;1. MD/PhD Program, School of Medicine, Emory University, Suite 375-B, 1648 Pierce Drive, Atlanta, GA 30322, USA;2. Department of Neurosurgery, Emory University, 1365-B Clifton Road Northeast, Suite 2200, Atlanta, GA 30322, USA;1. University of Nantes, Laboratory “Motricité, Interactions, Performance” (EA 4334), Nantes, France;2. The University of Queensland, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, St. Lucia, Queensland, Australia;1. Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida;2. College of Nursing, University of Florida, Gainesville, Florida;3. College of Medicine, University of Florida, Gainesville, Florida;4. Division of Clinical Immunology and Rheumatology, University of Alabama-Birmingham College of Medicine, Birmingham, Alabama;5. Department of Biostatistics, School of Public Health, University of Alabama-Birmingham, Birmingham, Alabama;1. Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium;2. Department of Experimental Psychology, Ghent University, Ghent, Belgium;3. Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium;4. Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada;1. INSERM, UMR 825, Toulouse, France;2. Université de Toulouse, UPS, UMR 825, Toulouse, France;3. Centre Hospitalier Universitaire de Toulouse, Service de Neurologie, Toulouse, France;4. Centre Hospitalier Universitaire de Toulouse, Service de Médecine Nucléaire, Toulouse, France;5. Centre Hospitalier Universitaire de Toulouse, Service de Psychiatrie, Toulouse, France;6. Centre Hospitalier Universitaire de Toulouse, Service de Neurochirurgie, Toulouse, France;7. Service de Pharmacologie Clinique, Faculté de Médecine, Toulouse, France |
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| Abstract: | Deep brain stimulation (DBS) of the periventricular/periaqueductal gray area and sensory thalamus can reduce pain intensity in patients with neuropathic pain. However, little is known about its impact on quality of life, emotional well-being, and cognition. This study followed up 18 patients who had received DBS for neuropathic pain. Each participant had previously undergone psychometric evaluation of each of the above areas as part of a routine presurgical neuropsychological assessment. Commensurate measures were employed at a follow-up assessment at least 6 months postsurgery. DBS significantly improved mood, anxiety, and aspects of quality of life. Improvements correlated with reduced pain severity. However, the sample continued to show impairments in most areas when compared against normative data published on nonclinical samples. There was little change in general cognitive functioning, aside from deterioration in spatial working memory. However, improvements in pain severity were associated with less improvement (and even deterioration) on measures of executive cognitive functioning. Improvements in emotional well-being also were correlated with changes in cognition. These results suggest that DBS of the periventricular/periaqueductal gray and/or sensory thalamus improves quality of life and emotional well-being in sufferers, although there is some indication of executive dysfunction, particularly among those reporting greatest pain alleviation.PerspectiveThis article examines the neuropsychological outcomes of DBS surgery as a treatment for neuropathic pain. This intervention was found to improve pain severity, emotional well-being, and quality of life, although such benefits may be accompanied by reduced ability on tasks measuring executive functioning. |
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| Keywords: | Chronic pain neuropathic pain deep brain stimulation cognition mood |
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