Chronic neuropathic pain affects 7%–10% of the population. Deep brain stimulation (DBS) has shown variable but promising results in its treatment. This study prospectively assessed the long-term effectiveness of DBS in a series of patients with chronic neuropathic pain, correlating clinical results with neuroimaging. Sixteen patients received 5 years’ post-surgical follow-up in a single center. Six had phantom limb pain after amputation and 10 had deafferentation pain after traumatic brachial plexus injury. Patient-reported outcome measures were completed before and after surgery, using VAS, UWNPS, BPI and SF-36 scores. Neuroimaging evaluated electrode location and effective volumes of activated tissue (VAT). Two subgroups were created based on the percentage of VAT superimposed upon the ventroposterolateral thalamic nucleus (eVAT), and clinical outcomes were compared. Analgesic effect was assessed at 5 years and compared to preoperative pain, with an improvement on VAS of 76.4% (p = 0.0001), on UW-NPS of 35.2% (p = 0.3582), on BPI of 65.1% (p = 0.0505) and on SF-36 of 5% (p = 0.7406). Eight patients with higher eVAT showed improvement on VAS of 67.5% (p = 0.0017) while the remaining patients, with lower eVAT, improved by 50.6% (p = 0.03607). DBS remained effective in improving chronic neuropathic pain after 5 years. While VPL-targeting contributes to success, analgesia is also obtained by stimulating surrounding posterior ventrobasal thalamic structures and related spinothalamocortical tracts.

慢性神经性疼痛影响 7%–10% 的人口。深部脑刺激（DBS）在其治疗中显示出可变但有希望的结果。本研究前瞻性地评估了 DBS 在一系列慢性神经性疼痛患者中的长期有效性，将临床结果与神经影像学相关联。16 名患者在一个中心接受了 5 年的术后随访。6 人在截肢后出现幻肢痛，10 人在外伤性臂丛神经损伤后出现传入神经痛。患者报告的结果测量在手术前后完成，使用 VAS、UWNPS、BPI 和 SF-36 评分。神经影像评估电极位置和有效组织体积 (VAT)。根据叠加在丘脑腹后外侧核 (eVAT) 上的增值税百分比，创建了两个亚组，和临床结果进行了比较。镇痛效果在 5 年时进行评估，与术前疼痛相比，VAS 改善了 76.4%。p  =  0.0001)，UW-NPS 为 35.2% ( p  =  0.3582)，BPI 为 65.1% ( p  =  0.0505)，SF-36 为 5% ( p  =  0.7406)。八名 eVAT 较高的患者的 VAS 改善了 67.5% ( p  =  0.0017)，而其余 eVAT 较低的患者改善了 50.6% ( p  =  0.03607)。5 年后，DBS 在改善慢性神经性疼痛方面仍然有效。虽然 VPL 靶向有助于成功，但也可以通过刺激周围的后腹基底丘脑结构和相关的脊髓丘脑皮质束来获得镇痛。