Severe, refractory CPSP, which is experienced by one in 12 stroke patients, is caused when the stroke affects the areas of the brain and central nervous system that process pain signals from the body.
CPSP can be disabling for those affected by it, and for some patients it does not respond to the current best medical treatment.
The EPIONE study, which is investigating whether DBS could be effective in treating CPSP, is supported by the National Institute for Health and Care Research (NIHR) Oxford and Oxford Health Biomedical Research Centres (BRC).
DBS works by delivering a gentle electrical stimulation directly to specific brain areas through thin electrode wires. The level of stimulation can be adjusted depending on how it affects symptoms, meaning it can be tailored to each individual.
Alex Green, Professor of Neurosurgery, who is leading the study, said: “DBS has been used to treat other conditions, such as tremors in Parkinson’s patients, and has even been used to tackle pain in specialist clinics. However, there is not enough high-quality evidence that DBS works reliably for pain in CPSP to justify its routine use in the NHS.”
The EPIONE study team will carry out a randomised study in 30 patients with CPSP who will receive treatment from a DBS device called a Picostim®-DyNeuMo. The results of this study will inform whether this treatment could be delivered by the NHS in future.
“Once the clinical team are happy that the patient has recovered well from the surgery, we will adjust the DBS settings to achieve pain relief. We will then compare the response to an ‘on’ setting to an ‘off’(called pseudo-on because it still drains the battery). The order of the two settings will be decided at random before the device is switched on. This will allow us to fairly assess which of the settings is most effective at treating CPSP in each participant,” Professor Green explained.
Read the full story on the NIHR Oxford Biomedical Research Centre website.