Deep brain stimulation as a treatment for chronic pain: A narrative and historical review

Chronic pain is one of the most common causes for patients to seek medical aid, but the currently available therapeutic interventions fail to meet the needs of many patients. Deep brain stimulation (DBS) has been proposed for years as an alternative treatment for chronic pain, though data supporting the use of the technique is mixed. This narrative review summarizes the current state of DBS as a treatment for chronic pain, including recent experiments in both humans and animal models. First, we summarize the current understanding of the interconnected networks in the brain responsible for the experience of pain and the impact of chronic pain on key regions in these networks. Next, a brief history of DBS and its uses in relation to chronic pain provide context for contemporary applications. Important technical considerations including stimulation parameters, anatomical targets, and cohort selection are summarized and reviewed in terms of efficacy and reliability. To improve future work, we also explore the role of placebo analgesia in DBS studies and provide recommendations. Altogether, this review provides an overview on the current state of DBS in the chronic pain field and proposes how future research may confirm the efficacy of DBS as a treatment for chronic pain.