CNRP-SCI: Cingulotomy for refractory neuropathic pain in SCI

Led by City St George's, University of London

Researchers are investigating the effectiveness of a procedure called cingulotomy, a minimally invasive surgical intervention that is able to locate and target a specific region of the brain with pinpoint accuracy, to help hinder overactive nerve pathways which regulate chronic pain in SCI individuals.

Commenting on being awarded funding for the project, Mr Erlick Pereira, Consultant Neurosurgeon at St George's University Hospital and lead researcher for the project, said: “Neuropathic pain is very common following spinal cord injury, with significant long-term impact on an individual’s quality of life, functional ability and mental health, as well as increased utilisation of health care resources. For some patients, this condition is resistant to existing treatments for CNP and has a devastating effect on their lives and the lives of their families. We are grateful to Spinal Research and Stoke Mandeville Spinal Research for the pledge to fund this project, and hope that the research will identify cingulotomy as a safe and effective option for patients and provide them with relief.”

This project is jointly funded by SMSR and Spinal Research 

Update May 2023

Recruitment has been slower than expected due to the ethical requirement to exhaust all other treatment options before offering the procedure - most patients have not yet tried less risky procedures such as Spinal Cord Stimulation (SCS). The research design has been amended to include a control group of SCS patients and there is an emphasis on investigating SCS in these patients to make the data more robust. The researchers are studying various markers in patients undergoing SCS treatment for pain, including those with SCI, in keeping with the study’s original aims to improve neurosurgery for pain in SCI. The goal is still to recruit 6 cingulotomy patients with SCI and explore its effects on neuropathic pain.

Update 2025

The team have published their results on the effectiveness of Spinal Cord Stimulation to treat pain, finding that a majority of people using it experienced at least 50% reduction in pain levels, and reductions in the use of pain medication. This can help reduce side effects for patients, as well as saving the NHS money. 

One patient has undergone a cingulotomy and is be followed up in line with the study protocol.