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To the Editor:Surgical implantation of electrodes into deep brain structures for the management of conditions such as chronic pain provides an opportunity for assessment of the physiological impact of stimulation of focal brain nuclei in humans.1 Recent studies in humans have suggested that stimulation of the periventricular (PVG)/periaqueductal grey (PAG) regions can result in changes in systemic blood pressure (BP).2,3 In the present case, we examined the physiological impact of such stimulation in humans by obtaining continuous measures of limb blood flow, peripheral resistance, stroke volume, and heart rate (HR) during deep brain stimulation (DBS) of the PVG/PAG. The patient, a 55-year–old woman, was referred for management of recalcitrant chronic neuropathic, phantom limb pain (affecting both lower limbs) in 2004, subsequently leading to PVG/PAG DBS surgery in 2005 at the Radcliffe Infirmary in Oxford.Assessments and procedures were approved by the Oxford Ethics Committee and performed in a quiet thermostatically controlled room (26°C). The patient was placed in a semirecumbent position, at which point the stimulator was turned off for an initial 20-minute rest period. After a baseline BP assessment using a Finometer PRO (Finapres Medical Systems, Amsterdam, Netherlands), the stimulator was turned on, and BP, stroke volume, total peripheral resistance, and brachial artery diameter and blood flow velocity (Terason T3000, Teratech …

Deep Brain Stimulation of the Periaqueductal Grey Induces Vasodilation in Humans