Deep Brain Stimulation for Chronic Facial Pain: An Individual Participant Data (IPD) Meta-Analysis

Qassim H, Zhao Y, Ströbel A, Regensburger M, Buchfelder M, Souza de Oliveira D, Del Vecchio A, Kinfe TM (2023)

Publication Type: Journal article, Review article

Publication year: 2023

Journal

Brain Sciences MDPI

Book Volume: 13

Article Number: 492

Journal Issue: 3

DOI: 10.3390/brainsci13030492

Abstract

Despite available, advanced pharmacological and behavioral therapies, refractory chronic facial pain of different origins still poses a therapeutic challenge. In circumstances where there is insufficient responsiveness to pharmacological/behavioral therapies, deep brain stimulation should be considered as a potential effective treatment option. We performed an individual participant data (IPD) meta-analysis including searches on PubMed, Embase, and the Cochrane Library (2000–2022). The primary endpoint was the change in pain intensity (visual analogue scale; VAS) at a defined time-point of ≤3 months post-DBS. In addition, correlation and regression analyses were performed to identify predictive markers (age, duration of pain, frequency, amplitude, intensity, contact configuration, and the DBS target). A total of seven trials consisting of 54 screened patients met the inclusion criteria. DBS significantly reduced the pain levels after 3 months without being related to a specific DBS target, age, contact configuration, stimulation intensity, frequency, amplitude, or chronic pain duration. Adverse events were an infection or lead fracture (19%), stimulation-induced side effects (7%), and three deaths (unrelated to DBS—from cancer progression or a second stroke). Although comparable long-term data are lacking, the current published data indicate that DBS (thalamic and PVG/PAG) effectively suppresses facial pain in the short-term. However, the low-quality evidence, reporting bias, and placebo effects must be considered in future randomized-controlled DBS trials for facial pain.

Authors with CRIS profile

HebatAllah Qassim Professur für Neurochirurgie mit dem Schwerpunkt Funktionelle Stereotaktische Neurochirurgie Yining Zhao Department of Neurosurgery Martin Regensburger Department of Molecular Neurology Michael Buchfelder Lehrstuhl für Neurochirurgie Daniela Souza de Oliveira Department Artificial Intelligence in Biomedical Engineering Alessandro Del Vecchio Juniorprofessur für Neuromuscular Physiology and Neural Interfacing Thomas Mehari Kinfe Professur für Neurochirurgie mit dem Schwerpunkt Funktionelle Stereotaktische Neurochirurgie

How to cite

APA:

Qassim, H., Zhao, Y., Ströbel, A., Regensburger, M., Buchfelder, M., Souza de Oliveira, D.,... Kinfe, T.M. (2023). Deep Brain Stimulation for Chronic Facial Pain: An Individual Participant Data (IPD) Meta-Analysis. Brain Sciences, 13(3). https://dx.doi.org/10.3390/brainsci13030492

MLA:

Qassim, HebatAllah, et al. "Deep Brain Stimulation for Chronic Facial Pain: An Individual Participant Data (IPD) Meta-Analysis." Brain Sciences 13.3 (2023).

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