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. 2020 Nov 7;21(7):1415-1420.
doi: 10.1093/pm/pnz371.

A Systematic Literature Review of Brain Neurostimulation Therapies for the Treatment of Pain

Timothy R Deer  1 , Steven Falowski  2 , Jeff E Arle  3 , Jan Vesper  4 , Julie Pilitsis  5 , Konstantin V Slavin  6 , Maria Hancu  5 , Jay S Grider  7 , Alon Y Mogilner  8
Affiliations

A Systematic Literature Review of Brain Neurostimulation Therapies for the Treatment of Pain

Timothy R Deer et al. Pain Med. .

Abstract

Objective: To conduct a systematic literature review of brain neurostimulation for pain.

Design: Grade the evidence for deep brain neurostimulation (DBS).

Methods: An international, interdisciplinary work group conducted a literature search for brain stimulation. Abstracts were reviewed to select studies for grading. Randomized controlled trials (RCTs) meeting inclusion/exclusion criteria were graded by two independent reviewers. General inclusion criteria were prospective trials (RCTs and observational) that were not part of a larger or previously reported group. Excluded studies were retrospective or existed only as abstracts. Studies were graded using the modified Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment, the Cochrane Collaborations Risk of Bias assessment, and the United States Preventative Services Task Force level-of-evidence criteria.

Results: Two high-quality RCTs and three observational trials supported DBS, resulting in Level II (moderate) evidence.

Conclusion: Moderate evidence supports DBS to treat chronic pain. Additional Level I RCTs are needed to further the strength of the evidence in this important area of medicine, but the current evidence suggests that DBS should be considered as an option in treating complex pain cases.

Keywords: Chronic Pain; Deep Brain Stimulation; Pain Management; Systematic Review.

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Figures

Figure 1
Figure 1
PRISMA diagram illustrating the literature used in the creation of the systematic review of DBS studies.
See this image and copyright information in PMC

Comment in

References

    1. Deer TR, Narouze S, Provenzano DA, et al. The Neurostimulation Consensus Committee (NACC) recommendations on bleeding and coagulation management in neurostimulation devices. Neuromodulation 2017;20(1):51–62. - PubMed
    1. Deer TR, Provenzano DA, Hanes M, et al. The Neurostimulation Appropriateness Consensus Committee (NACC) recommendations for infection prevention and management. Neuromodulation 2017;20(1):31–50. - PubMed
    1. Deer TR, Lamer TJ, Pope J, et al. The Neurostimulation Consensus Committee (NACC) safety guidelines for the reduction of severe neurological injury. Neuromodulation 2017;20(1):15–30. - PubMed
    1. Deer TR, Provenzano D, Pope J, et al. The appropriate use of neurostimulation of the spinal cord and peripheral nervous system for the treatment of chronic pain and ischemic diseases: The Neuromodulation Appropriateness Consensus Committee (NACC). Neuromodulation 2014;17(6):515–50. - PubMed
    1. Deer TR, Levy RM, Petersen E, et al. The appropriate use of neurostimulation: Stimulation of the intracranial and extracranial space and head for chronic pain. Neuromodulation 2014;17(6):551–70. - PubMed

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