Thalamic-Burst-DBS for Neuropathic Pain

Prior treatment

• Contra-indication to surgery, anesthesia, or MRI
• Participation in another interventional clinical trial within 30 days prior to this trial or during the trial
• Previous enrollment into the current trial
• Patients who are planned to undergo diathermy, electroshock therapy or transcranial magnetic stimulation (TMS)

Other illness

• DSMIV axis I or II psychiatric disorder
• Relevant psychosocial risk factors (any of): history of other chronic pain syndrome, pain catastrophizing, substance abuse, secondary gain
• Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia. etc. of the subject
• Patients with implanted electric devices (i.e. cardiac defibrillator, pacemaker)
• Patients who are at poor surgical risk (i.e. patients with multiple severe illnesses or active general infections)

Age

• Significant cognitive impairment (total MOCA score \< 1.5 standard deviations from age- and education adapted mean values),

Other

• Known or suspected non-compliance or inability to operate the DBS system
• Woman with childbearing potential
• Enrolment of the investigator's family members, employees, and other dependent persons

• Signed informed consent
• Age 18-75 years
• Patients suffering from chronic (duration \> 12 months) unilateral neuropathic pain caused by an ischemic or haemorrhagic cerebral stroke or
• Patients suffering from chronic (duration \> 12 months) unilateral neuropathic facial pain due to one of the following causes:
  • post-herpes-zoster-neuralgia,
  • posttraumatic, neuropathic facial pain,
  • atypical trigeminal neuralgia after surgical intervention
• Severe baseline pain intensity (VAS score \> 6/10) considered as resistant to medication specific to neuropathic pain at sufficient doses and durations (including at least antiepileptics and antidepressants)