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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.
Ventral posterior medial (VPM) stimulation in
combination with centromedian (CM) stimulation was found to be a promising
target for 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.
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.
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.
Directional deep brain stimulation
can target the thalamic optimal target and minimize neuropathic dental pain.
Operative Neurosurgery
Directional Deep Brain Stimulation Can Target the Thalamic "Sweet Spot" for Improving Neuropathic Dental Pain
Marie T Krüger et al.
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