Closed-Loop Deep Brain Stimulation for Refractory Chronic Pain Using Summit RC+S
University of California, San Francisco
Summary
Chronic pain affects 1 in 4 US adults, and many cases are resistant to almost any treatment. Deep brain stimulation (DBS) holds promise as a new option for patients suffering from treatment-resistant chronic pain, but traditional approaches target only brain regions involved in one aspect of the pain experience and provide continuous 24/7 brain stimulation which may lose effect over time. By developing new technology that targets multiple, complimentary brain regions in an adaptive fashion, the investigators will test a new therapy for chronic pain that has potential for better, more enduring analgesia.
Description
A diverse array of chronic pain syndromes are refractory to almost all treatment but involve pathological activity in similar brain regions. This suggests therapeutic potential for deep brain stimulation (DBS) for refractory pain disorders, but despite early promise, long-term efficacy is lacking. Current DBS devices are limited in anatomical reach, targeting only a subset of the distinct brain regions known to be important. Further, DBS therapy is bluntly applied in an "open-loop," continuous fashion without regard to underlying physiology. As a result of these shortcomings, DBS for pain is o…
Eligibility
- Age range
- 22–80 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Age 22-80 years old 2. Clinical diagnosis of a refractory chronic pain syndrome including 1. post-traumatic pain syndromes (e.g. root avulsions, nerve crush injuries, spinal cord injury) 2. postsurgical pain syndromes (e.g., postmastectomy syndrome, post-thoracotomy syndrome, phantom limb pain, post-surgical spinal pain) 3. postherpetic neuralgia 4. complex regional pain syndrome 5. atypical facial pain 6. central pain syndromes (e.g. post-stroke pain, multiple sclerosis pain, post-radiation pain) 7. post-radiation plexopathy 3. Two or more years o…
Interventions
- DeviceMedtronic Summit RC+S or Percept RC
The investigators will perform DBS versus sham (randomized) to evaluate efficacy of stimulation for analgesia. Closed-loop DBS will be compared to open-loop DBS in a patient blinded, randomized fashion after initial, efficacy evaluation.
Location
- University of California, San FranciscoSan Francisco, California