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      Neuromodulation of the cingulum for neuropathic pain after spinal cord injury. Case report.

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          Abstract

          The authors present a case in which high-frequency electrical stimulation of the cingulum using standard deep brain stimulation (DBS) technology resulted in pain relief similar to that achieved with cingulotomy and superior to that achieved with periventricular gray matter (PVG) stimulation. This patient had a complete spinal cord injury at the C-4 level and suffered from medically refractory neuropathic pain. He underwent placement of bilateral cingulum and unilateral PVG DBS electrodes and a 1-week blinded stimulation trial prior to permanent implantation of a pulse generator. During the stimulation trial, the patient's pain level was assessed using a visual analog scale, and pain medication usage was recorded. During this period the patient was blinded to stimulation parameters. Stimulation of the cingulum provided better pain control than PVG stimulation or medication alone. The authors believe that cingulum stimulation can benefit patients with severe neuropathic pain that is refractory to other treatments. Advantages over cingulotomy include reversibility and the ability to adjust stimulation parameters for optimum efficacy.

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          Author and article information

          Journal
          J. Neurosurg.
          Journal of neurosurgery
          Journal of Neurosurgery Publishing Group (JNSPG)
          0022-3085
          0022-3085
          Jul 2007
          : 107
          : 1
          Affiliations
          [1 ] Department of Neurological Surgery, Section of Functional Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2380, USA.
          Article
          10.3171/JNS-07/07/0169
          17639889

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