Short Communication - Journal of Evolutionary Medicine ( 2023) Volume 11, Issue 1
Novel Approaches in Chronic facial Pain and Parkinson's by Deep Brain StimulationRazieh Gray*
Razieh Gray, Department of Maxillofacial Medicine and Surgery, Medical University of Vienna, Austria, Email: firstname.lastname@example.org
Received: 02-Jan-2023, Manuscript No. JEM-23-92326; Editor assigned: 04-Jan-2023, Pre QC No. JEM-23-92326 (PQ); Reviewed: 18-Jan-2023, QC No. JEM-23-92326; Revised: 23-Jan-2023, Manuscript No. JEM-23-92326 (R); Published: 30-Jan-2023, DOI: 10.4303/JEM/236005
Despite the availability of cutting-edge pharmaceutical and behavioral treatments, treating intractable persistent facial pain from a variety of causes remains difficult. Deep brain stimulation should be taken into consideration as a possible successful therapy choice when pharmacological and behavioral treatments are ineffective. Parkinson’s disease and other neurological diseases can now be effectively treated with Deep Brain Stimulation (DBS), which involves implanting a device into the Subthalamic Nucleus (STN). Currently used normal common High-Frequency Stimulation (HF) has a number of disadvantages. The quantity of current delivered is switched on and off in real-time in response to a biophysical signal in closed-loop and demand-controlled, adaptive stimulation methods, which researchers have been creating to get around the constraints of HF. The creation of novel methods that help researchers in animal and human studies is aided by computational modeling of DBS in neural network models.
In this computational research, we attempt to put into practice a new DBS method where we adaptively activate the STN using the neurons’ interspike times as a control. Our findings demonstrate that the STN’s synchronized bursting neuronal activity, which is thought to be the root of Thalamocortical Neurons’ (TC) inability to react appropriately to excitatory cortical inputs, is eliminated by our procedure. Additionally, we are able to greatly reduce the TC relay errors, suggesting possible Parkinson’s disease treatments.
According to the more pronounced symptoms, the Subthalamic Nucleus (STN), Globus Pallidus (GP), or thalamus may be medically inserted with a stimulating electrode as part of Deep Brain Stimulation (DBS), a treatment choice for Parkinson’s disease (PD). The brain’s specific areas receive electrical signals from the stimulating electrode. The most common DBS procedures currently use open-loop techniques that involve continuous High-Frequency Stimulation (HF). The pathogenesis of PD is connected to modifications in the basal ganglia, including alterations to synchronization, firing rates, and burst activity. When stimulus is able to stop the pathological coordinated bursting in the basal ganglia, DBS may be effective therapeutically.
Although this therapy has been successful, HF DBS has a number of disadvantages. In open-loop techniques, the duration, amplitude, and frequency of the pulse train are stimulation factors that are not influenced by PD-related alterations in the electrical activity of the brain but rather by outside influences. Conventional HF DBS may have negative impacts close to the stimulation location due to its high frequency and fixed settings. With greater frequency and open-loop DBS, there are also issues with battery life and gadget storage life.
For those who suffer from it, chronic pain is a huge hardship that also lowers quality of life. In contemporary developed nations, 20%-30% of the populace experiences chronic pain from a variety of causes. One of the most prevalent categories of persistent pain in Western developed nations is facial pain, which accounts for 26% of cases. Regardless of the distinct variations in the pathophysiology of facial pain syndromes, primary therapies including as pharmacotherapies, behavioral therapies and fewer invasive neurostimulation methods (peripheral nerve stimulation and occipital nerve stimulation) are unsuccessful to accomplish an endured and meaningful responsiveness.
Additional useful treatments could be used, depending on the kind. The use of Motor Cortex Stimulation (MCS), a more intrusive technique, has proven to be a successful choice for treating persistent facial discomfort. In circumstances where there is inadequate responsiveness to MCS, Deep Brain Stimulation (DBS) serves as an additional, nevertheless more invasive, therapy option for chronic facial pain; subsequently, negative results arising from two randomized-controlled trials at the completion of the last century stated a negative treatment outcome. According to the pain syndrome, various DBS targets have been identified in prior research.
Numerous investigations in humans have focused on the central median nucleus/Parafascicular Complex (Cm-Pf), the thalamic nuclei Ventralis Posteromedialis (VPM) and Ventralis Posterolateralis (VPL), as well as the Periventricular/ Peri-Aqueduct Grey (PVG/PAG) of the brainstem [1-4].
On the other hand, experimental cohort studies, case series, and/or small-scale ungoverned trials have delivered low-level testimony for the use of DBS in the implementation. of facial pain syndromes with regard to the heterogeneity of the data released with respect to the DBS target, stimulation patterns, facial pain etiology, hardware-/stimulation-associated adverse events, and the notice period post-DBS.
As a result, there are still unanswered issues that have been the subject of continuing discussion and advice. In order to answer the issues above, we conducted a meta-analysis of Individual Participant Data (IPD) from patients who received deep brain stimulation for persistent facial pain.
Authors do not have acknowledgments currently.
Conflict of Interest
There are no conflicts of interest.
- FE Fox, M Morris, N Rumsey, Doing synchronous online focus groups with young people: Methodological reflections. Qual Healt Res 17 (2007) 539-547.
- MK Murphy, RF MacBarb, ME Wong, KA Athanasiou, Temporomandibular disorders: A review of etiology, clinical management, and tissue engineering strategies. The Inter J Oral Maxi Impl 28 (2013) e393-e414.
- M Farr, H Brant, R Patel, MJ Linton, N Ambler, et al., Experiences of patient-led chronic pain peer support groups after pain management programmes: A qualitative study. Pa Med 22 (2021) 2884-2895.
- C Ainsley, A Bradshaw, C Murray, N Goss, S Harrison, et al., Experiences and outcomes of attending a facial pain management program: A qualitative study. J Oral Fac Pai Head, 35 (2021)208-217.
Copyright: © 2023 Razieh Gray. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.