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Related Experiment Video

Updated: Sep 11, 2025

Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
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Insula Deep Brain Stimulation for Neuropathic Pain: A Cross-Over, Randomized, Sham-Controlled Trial.

Liu Dongyang1, Pedro Henrique M Cunha1, Jorge D S Lapa1

  • 1LIM-62, Pain Center, Division of Neurosurgery, Department of Neurology, University of Sao Paulo Medical School, São Paulo, Brazil.

Neuromodulation : Journal of the International Neuromodulation Society
|August 18, 2025
PubMed
Summary
This summary is machine-generated.

Deep brain stimulation of the posterior-superior insula shows promise for treating refractory neuropathic pain. This intervention demonstrated improved pain reduction, mood, and quality of life with a good safety profile.

Keywords:
Chronic paindeep brain stimulationneuromodulationneurosurgeryperipheral neuropathy

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Area of Science:

  • Neurology
  • Neurosurgery
  • Pain Medicine

Background:

  • Neuropathic pain affects many individuals, with a significant subset experiencing refractory conditions.
  • Current treatments for neuropathic pain are often insufficient for a substantial number of patients.
  • The posterior-superior insula is implicated in pain processing and modulation.

Purpose of the Study:

  • To evaluate the efficacy and safety of posterior-superior insula deep brain stimulation (DBS) for patients with pharmaco-resistant neuropathic pain.
  • To determine if DBS of the posterior-superior insula can reduce pain intensity and improve quality of life in this patient population.

Main Methods:

  • A phase 2, randomized, double-blind, sham-controlled, cross-over trial was conducted.
  • Participants with chronic, pharmaco-resistant neuropathic pain received either active or sham DBS targeting the posterior-superior insula.
  • Primary outcome was ≥30% reduction in average pain intensity; secondary outcomes included pain interference, quality of life, and neuropsychiatric assessments.

Main Results:

  • Ten participants were enrolled in the study.
  • Active posterior-superior insula DBS showed a high probability of yielding a greater responder rate compared to sham stimulation.
  • Significant improvements were observed in pain interference, particularly sleep and mood, and quality of life scores with active stimulation.

Conclusions:

  • Posterior-superior insula DBS is a feasible and potentially effective treatment for refractory neuropathic pain.
  • The intervention demonstrated a reasonable safety profile and was well-tolerated.
  • Further phase 3 trials are recommended to confirm these findings and explore broader applicability.