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Zhao H, Zhang S, Wang Y, Zhang C, Gong Z, Zhang M, Dai W, Ran Y, Shi W, Dang Y, Liu A, Zhang Z, Yeh CH, Dong Z, Yu S. A pilot study on a patient with refractory headache: Personalized deep brain stimulation through stereoelectroencephalography. iScience 2024; 27:108847. [PMID: 38313047 PMCID: PMC10837616 DOI: 10.1016/j.isci.2024.108847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/23/2023] [Accepted: 01/03/2024] [Indexed: 02/06/2024] Open
Abstract
The integration of stereoelectroencephalography with therapeutic deep brain stimulation (DBS) holds immense promise as a viable approach for precise treatment of refractory disorders, yet it has not been explored in the domain of headache or pain management. Here, we implanted 14 electrodes in a patient with refractory migraine and integrated clinical assessment and electrophysiological data to investigate personalized targets for refractory headache treatment. Using statistical analyses and cross-validated machine-learning models, we identified high-frequency oscillations in the right nucleus accumbens as a critical headache-related biomarker. Through a systematic bipolar stimulation approach and blinded sham-controlled survey, combined with real-time electrophysiological data, we successfully identified the left dorsal anterior cingulate cortex as the optimal target for the best potential treatment. In this pilot study, the concept of the herein-proposed data-driven approach to optimizing precise and personalized treatment strategies for DBS may create a new frontier in the field of refractory headache and even pain disorders.
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Affiliation(s)
- Hulin Zhao
- Department of Neurosurgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Shuhua Zhang
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Yining Wang
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Chuting Zhang
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
| | - Zihua Gong
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Mingjie Zhang
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Wei Dai
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Ye Ran
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Wenbin Shi
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Key Laboratory of Brain Health Intelligent Evaluation and Intervention, Beijing Institute of Technology, Ministry of Education, Beijing 100081, China
| | - Yuanyuan Dang
- Department of Neurosurgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Aijun Liu
- Department of Neurosurgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhengbo Zhang
- Center for Artificial Intelligence in Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Chien-Hung Yeh
- School of Information and Electronics, Beijing Institute of Technology, Beijing 100081, China
- Key Laboratory of Brain Health Intelligent Evaluation and Intervention, Beijing Institute of Technology, Ministry of Education, Beijing 100081, China
| | - Zhao Dong
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China
- International Headache Centre, Chinese PLA General Hospital, Beijing 100853, China
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Almuwais A, Lagrand TJ, Lehn AC. Case report: Migraine resolution post bilateral subthalamic deep brain stimulation. CEPHALALGIA REPORTS 2023. [DOI: 10.1177/25158163221150618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Chronic migraine can be challenging to treat and despite recent advances in treatment, there are cases that do not respond to current available pharmacological therapies. Case: We report a case of a 64-year-old male with a long history of chronic migraine who developed severe tremor-dominant Parkinson’s disease. Conclusion: After implantation of subthalamic deep brain stimulation (DBS), he reported not only benefit for his parkinsonian symptoms, but also a complete remission of his migraine attacks.
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Affiliation(s)
- Ahmed Almuwais
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Tjerk J Lagrand
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia
| | - Alexander C Lehn
- Department of Neurology, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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