Closed-loop Deep Brain Stimulation to Treat Refractory Neuropathic Pain

Inclusion Criteria: * Age ≥ 21 years * Clinical diagnosis of post-stroke pain (thalamic pain), spinal cord injury or phantom limb pain with allodynia or dysesthesia with pinprick anesthesia or hypoesthesia on the affected hemibody or limb (anesthesia dolorosa). * For Post-Stroke Pain: Stroke of ischemic etiology only. MRI done within one year of the first visit showing a lesion that involves the contralateral brainstem, thalamus or cortex. The lesion will involve cortical-subcortical areas in topography consistent with sensory thalamocortical connections. This will include patients with infarcts in the territory of the middle cerebral artery or those with cavernous malformations. A more recent MRI may be required if the patient's condition changed within the previous year. * For Phantom limb pain: MRI done within one year not showing any contraindication to surgery such as mass, lesion, hemorrhage or other abnormality near target * For Spinal Cord Injury pain: MRI done within one year not showing contraindication to surgery such as mass, lesion, hemorrhage or other abnormality near target * One year or more of medically refractory severe pain (see below) * Average daily pain for the past 30 days reported as \>5 on a 0-10 numeric rating scale (NRS) * Failure to respond adequately to at least one antidepressant, one anti-seizure medication and one oral narcotic with current stable doses of medications. * Ability to speak / read English * Capable of understanding and providing informed consent * Stable doses of pain medications (e.g. anticonvulsant drug, anti-depressants, and opioids etc.) * Women of childbearing age must be on regular use of an accepted contraceptive method(s). Exclusion Criteria: * Study subjects will be adults with refractory chronic neuropathic pain. * Pregnancy or breast feeding * Inability to speak and / or read English * Inability to give informed consent * Significant cognitive impairment or Dementia (MoCA \< 25) * Aphasia severe enough to limit the consent process or communication between the investigators and the patient. Patients with mild or recovering aphasia may be considered candidates at the discretion of the PI. * Active depression (BDI \> 20) or other untreated or uncontrolled psychiatric illness (active general anxiety disorder, schizophrenia, bipolar disorder, obsessive-compulsive disorder (OCD), or personality disorders (e.g. multiple personality disorder, borderline personality disorder, etc.) or other neuropsychiatric c…