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Brain Sciences
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Noninvasive and Invasive Brain Modulation Targeting the Limbic Pain Matrix
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Noninvasive and Invasive Brain Modulation Targeting the Limbic Pain Matrix

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuroscience of Pain".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 10667

Special Issue Editor

Prof. Dr. Thomas M. Kinfe

E-Mail Website
Guest Editor
Department of Neurosurgery, Division of Functional Neurosurgery and Stereotaxy Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg Schwabachanlage 6, 91054 Erlangen, Germany
Interests: brain stimulation; spinal neuromodulation; neurorestorative therapies; innovative neurotechnology; movement disorders; chronic pain; neuropsychiatric disorders; MRI based functional neurosurgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Background & history: In case chronic pain individuals fail to achieve sustained pain relief, adjunct non-invasive and invasive brain modulation (stimulation / lesioning) represent a reasonable and synergistic treatment option. Whilst the majority of the applied brain stimulation methods intended to modulate sensory-associated pain circuits, targeted brain modulation of affective cognitive neural pain transmission gained increased research and clinical recognition.

Aim and scope: Invasive deep brain stimulation, radiofrequency ablation, gamma knife radiosurgery, and MR-guided focused ultrasound represent treatment modalities that have been trialed in a reasonable number of in-human pain studies. However, in-human studies, including invasive and non-invasive brain modulation techniques, targeting solely or in combination with the limbic pain-associated brain structures either on the surface or deeper brain structures are lacking. Thus, the aim of this Special Issue ranges from noninvasive to invasive brain modulation techniques and from reversible neurostimulation to non-reversible lesioning procedures utilizing radiation or ultrasound in order to modulate affective cognitive limbic pathways relevant for pain perception and processing.

Cutting-edge research: Clinical reports of novel innovative brain stimulation patterns and ablative techniques derived from biomedical engineering using pain-associated brain network mapping (electrophysiology, neuroimaging, and molecular and digital phenotyping), as well as preclinical studies are encouraged to contribute.

Prof. Dr. Thomas M. Kinfe
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • deep brain stimulation
  • epidural brain stimulation
  • noninvasive brain stimulation
  • brain lesioning / ablation
  • limbic pain network
  • chronic pain
  • outcome measures

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Published Papers (4 papers)

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Editorial

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3 pages, 187 KiB  
Editorial
A Clarion Call for Neuroinflammatory Assays in Brain Stimulation for Chronic Pain
by Thomas Kinfe, Yining Zhao and Barbara Viviani
Brain Sci. 2022, 12(3), 364; https://doi.org/10.3390/brainsci12030364 - 9 Mar 2022
Viewed by 1878
Abstract
Chronic pain is characterized by an impaired functional state (pain, mood, sleep, cognition, and metabolism) affecting different brain networks relevant for pain perception and neural pain processing [...] Full article
(This article belongs to the Special Issue Noninvasive and Invasive Brain Modulation Targeting the Limbic Pain Matrix)

Research

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19 pages, 2626 KiB  
Article
Infraslow Neurofeedback Training Alters Effective Connectivity in Individuals with Chronic Low Back Pain: A Secondary Analysis of a Pilot Randomized Placebo-Controlled Study
by Divya Bharatkumar Adhia, Ramakrishnan Mani, Paul R. Turner, Sven Vanneste and Dirk De Ridder
Brain Sci. 2022, 12(11), 1514; https://doi.org/10.3390/brainsci12111514 - 8 Nov 2022
Cited by 6 | Viewed by 3810
Abstract
This study explored the effect of electroencephalographic infraslow neurofeedback (EEG ISF-NF) training on effective connectivity and tested whether such effective connectivity changes are correlated with changes in pain and disability in people with chronic low back pain. This involved secondary analysis of a [...] Read more.
This study explored the effect of electroencephalographic infraslow neurofeedback (EEG ISF-NF) training on effective connectivity and tested whether such effective connectivity changes are correlated with changes in pain and disability in people with chronic low back pain. This involved secondary analysis of a pilot double-blinded randomised placebo-controlled study. Participants (n = 60) were randomised to receive ISF-NF targeting either the pregenual anterior cingulate cortex (pgACC), dorsal anterior cingulate and somatosensory cortex (dACC + S1), ratio of pgACC*2/dACC + S1, or Sham-NF. Resting-state EEG and clinical outcomes were assessed at baseline, immediately after intervention, and at one-week and one-month follow-up. Kruskal–Wallis tests demonstrated significant between-group differences in effective connectivity from pgACC to S1L at one-month follow up and marginal significant changes from S1L to pgACC at one-week and one-month follow up. Mann–Whitney U tests demonstrated significant increases in effective connectivity in the ISF-NF up-training pgACC group when compared to the Sham-NF group (pgACC to S1L at one-month (p = 0.013), and S1L to pgACC at one-week (p = 0.008) and one-month follow up (p = 0.016)). Correlational analyses demonstrated a significant negative correlation (ρ = −0.630, p = 0.038) between effective connectivity changes from pgACC to S1L and changes in pain severity at one-month follow-up. The ISF-NF training pgACC can reduce pain via influencing effective connectivity between pgACC and S1L. Full article
(This article belongs to the Special Issue Noninvasive and Invasive Brain Modulation Targeting the Limbic Pain Matrix)
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Other

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14 pages, 1650 KiB  
Systematic Review
Deep Brain Stimulation for Chronic Facial Pain: An Individual Participant Data (IPD) Meta-Analysis
by Hebatallah Qassim, Yining Zhao, Armin Ströbel, Martin Regensburger, Michael Buchfelder, Daniela Souza de Oliveira, Alessandro Del Vecchio and Thomas Kinfe
Brain Sci. 2023, 13(3), 492; https://doi.org/10.3390/brainsci13030492 - 14 Mar 2023
Cited by 6 | Viewed by 2207
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Noninvasive and Invasive Brain Modulation Targeting the Limbic Pain Matrix)
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8 pages, 548 KiB  
Study Protocol
Treatment of Chronic Refractory Pain by Combined Deep Brain Stimulation of the Anterior Cingulum and Sensory Thalamus (EMOPAIN Study): Rationale and Protocol of a Feasibility and Safety Study
by Aurélie Leplus, Michel Lanteri-Minet, Anne Donnet, Nelly Darmon, Jean Regis and Denys Fontaine
Brain Sci. 2022, 12(9), 1116; https://doi.org/10.3390/brainsci12091116 - 23 Aug 2022
Cited by 4 | Viewed by 1989
Abstract
Background: Deep Brain Stimulation (DBS) of the sensory thalamus has been proposed for 40 years to treat medically refractory neuropathic pain, but its efficacy remains partial and unpredictable. Recent pilot studies of DBS targeting the ACC, a brain region involved in the integration [...] Read more.
Background: Deep Brain Stimulation (DBS) of the sensory thalamus has been proposed for 40 years to treat medically refractory neuropathic pain, but its efficacy remains partial and unpredictable. Recent pilot studies of DBS targeting the ACC, a brain region involved in the integration of the affective, emotional, and cognitive aspects of pain, may improve patients suffering from refractory chronic pain. ACC-DBS could be complementary to thalamic DBS to treat both the sensory-discriminative and the affective components of chronic pain, but the safety of combined DBS, especially on cognition and affects, has not been studied. Methods: We propose a prospective, randomized, double-blind, and bicentric study to evaluate the feasibility and safety of bilateral ACC-DBS combined with unilateral thalamic DBS in adult patients suffering from chronic unilateral neuropathic pain, refractory to medical treatment. After a study period of six months, there is a cross-over randomized phase to compare the efficacy (evaluated by pain intensity and quality of life) and safety (evaluated by repeated neurological examination, psychiatric assessment, cognitive assessment, and assessment of affective functions) of combined ACC-thalamic DBS and thalamic DBS only, respectively. Discussion: The EMOPAIN study will show if ACC-DBS is a safe and effective therapy for patients suffering from chronic unilateral neuropathic pain, refractory to medical treatment. The design of the study will, for the first time, assess the efficacy of ACC-DBS combined with thalamic DBS in a blinded way. Full article
(This article belongs to the Special Issue Noninvasive and Invasive Brain Modulation Targeting the Limbic Pain Matrix)
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