Latin American and Caribbean consensus on noninvasive central nervous system neuromodulation for chronic pain management (LAC2-NIN-CP)

Baptista, Abrahão Fontes; Fernandes, Ana Mércia; Sá, Kátia Nunes; Okano, Alexandre Hideki; Brunoni, André R.; Lara-Solares, Argelia; Iskandar, Aziza Jreige; Guerrero, C.; Amescua-García, César; Kraychete, Durval Campos; Caparelli-Dáquer, Egas; Atencio, Elias; Piedimonte, Fabián; Colimon, Frantz; Hazime, Fuad Ahmad; Garcia, João Batista Santos; Hernández-Castro, John Jairo; Cantisani, José Alberto Flores; Monte-Silva, Kátia; Correia, Luís Cláudio Lemos; Gallegos, Manuel Sempértegui; Marcolin, Marco Antônio; Ricco, María Antonieta; Cook, María Berenguel; Bonilla, Patricia; Schestatsky, Pedro; Galhardoni, Ricardo; Silva, Valquíria; Barrera, William Delgado; Caumo, Wolnei; Bouhassira, Didier; Chipchase, Lucinda S; Lefaucheur, Jean Pascal; Teixeira, Manoel Jacobsen; Andrade, Daniel Ciampi de

doi:10.1097/pr9.0000000000000692

Cited by 65 publications

(91 citation statements)

References 117 publications

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“…Non-specific LBP is the leading cause of years of unhealthy life in the world [48]. The prognosis of LBP patients is generally good since 90% of people recover within 3 months [45] thanks to a large therapeutic offering [29] including both pharmaceutical (non-steroidal anti-inflammatory drugs (NSAIDS), opioids, paracetamol) and non-pharmaceutical interventions (massage, physical therapy, acupuncture) [36] including neuromodulation techniques such as repeated Magnetic Stimulation (rTMS) and transcranial Direct Current Stimulations (tDCS) [4].…”

Section: -Introductionmentioning

confidence: 99%

Alpha-phase synchrony EEG training for multi-resistant chronic low back pain patients: an open-label pilot study

Mayaud

Wu²,

Barthélemy

et al. 2019

Eur Spine J

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Section: -Introductionmentioning

confidence: 99%

Alpha-phase synchrony EEG training for multi-resistant chronic low back pain patients: an open-label pilot study

Mayaud

Wu²,

Barthélemy

et al. 2019

Eur Spine J

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“…Besides, it can help to personalize the therapeutic approach. Despite the absence of a FDA-approved neuromodulation protocol targeted to patients with comorbidity MDD and FM, the effectiveness of neuromodulatory techniques (i.e., tDCS and TMS) has been supported by consistent evidence to treat both FM and depression (Kauffmann et al, 2004; Antal et al, 2010; Brunoni et al, 2011; Marie, 2014; Fagerlund et al, 2015; Castillo-Saavedra et al, 2016; Cheng et al, 2018; Karina do Monte-Silva et al, 2019). Considering that these two disorders are frequently overlapped, it poses a considerable challenge to decide if it would be better to stimulate the M1 or the dorsal lateral prefrontal cortex for the treatment of pain accompanied by depression.…”

Section: Discussionmentioning

confidence: 99%

Differential Neuroplastic Changes in Fibromyalgia and Depression Indexed by Up-Regulation of Motor Cortex Inhibition and Disinhibition of the Descending Pain System: An Exploratory Study

Cardinal

Antunes

Brietzke

et al. 2019

Front. Hum. Neurosci.

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Background: Major depressive disorder (MDD) and fibromyalgia (FM) present overlapped symptoms. Although the connection between these two disorders has not been elucidated yet, the disruption of neuroplastic processes that mediate the equilibrium in the inhibitory systems stands out as a possible mechanism. Thus, the purpose of this cross-sectional exploratory study was: (i) to compare the motor cortex inhibition indexed by transcranial magnetic stimulation (TMS) measures [short intracortical inhibition (SICI) and intracortical facilitation (ICF)], as well as the function of descending pain modulatory systems (DPMS) among FM, MDD, and healthy subjects (HS); (ii) to compare SICI, ICF, and the role of DPMS evaluated by the change on Numerical Pain Scale (NPS) during the conditioned pain modulation test (CPM-test) between FM and MDD considering the BDNF-adjusted index; (iii) to assess the relationship between the role of DPMS and the BDNF-adjusted index, despite clinical diagnosis. Patients and Methods: A cohort of 63 women, aged 18 to 75 years [FM ( n = 18), MDD ( n = 19), and HC ( n = 29)]. Results: The MANCOVA analysis revealed that the mean of SICI was 53.40% larger in FM compared to MDD [1.03 (0.50) vs. 0.55 (0.43)] and 66.99% larger compared to HC [1.03 (0.50) vs. 0.34 (0.19)], respectively. The inhibitory potency of the DPMS assessed by the change on the NPS during CPM-test was 112.29 % lower in the FM compared to MDD [0.22 (1.37) vs. −0.87 (1.49)]. The mean of BDNF from FM compared to MDD was 35.70% higher [49.82 (16.31) vs. 14.12 (8.86)]. In FM, the Spearman’s coefficient between the change in the NPS during CPM-test with the SICI was Rho = −0.49, [confidence interval (CI) 95%; −0.78 to −0.03]. The BDNF-adjusted index was positively correlated with the disinhibition of the DPMS. Conclusion: These findings support the hypothesis that in FM a deteriorated function of cortical inhibition, indexed by a higher SICI parameter, a lower function of the DPMS, together with a higher level of BDNF indicate that FM has different pathological substrates from depression. They suggest that an up-regulation phenomenon of intracortical inhibitory networks associated with a disruption of the DPMS function occurs in FM.

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“…To date, high frequency (i.e., more than 5 Hz) rTMS over M1 is the only validated protocol for pain treatment [9,10,39]. Although epidural motor cortex stimulation seems more effective if the motor representation of the painful area is stimulated [40], such somatotopy is not obvious using rTMS [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Although the link between M1 stimulation and pain relief is not obvious at first, M1 can be seen as an entry door into a larger network involved in pain modulation [41]. Concerning other non-invasive brain stimulation techniques for abdominal pain treatment, there is some evidence for the efficacy of anodal transcranial direct current stimulation (tDCS) over the primary motor cortex and recent guidelines provided a level B for its use in such pain situation [39]. In the case of rTMS, other possible brain targets for pain relief are under investigation, especially the dorsolateral prefrontal cortex (DLPFC) or deeper cortical areas [40].…”

Section: Discussionmentioning

confidence: 99%

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Repetitive Transcranial Magnetic Stimulation Therapy (rTMS) for Endometriosis Patients with Refractory Pelvic Chronic Pain: A Pilot Study

Pinot-Monange

Moisset

Chauvet

et al. 2019

JCM

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Endometriosis concerns more than 10% of women of reproductive age, frequently leading to chronic pelvic pain. Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) induces an analgesic effect. This effect on chronic pelvic pain is yet to be evaluated. The objective of this study was to assess the feasibility and effect of rTMS to reduce pain and improve quality of life (QoL) in patients with chronic pelvic pain due to endometriosis. This pilot, open-labelled prospective trial examined treatment by neuronavigated rTMS over M1, one session per day for 5 consecutive days. Each session consisted of 1.500 pulses at 10 Hz. We assessed tolerance, pain change and QoL until 4 weeks post treatment with a primary endpoint at day 8. Twelve women were included. No patients experienced serious adverse effects or a significant increase in pain. Nine women reported improvement on the Patient Global Impression of Change with a reduction in both pain intensity and pain interference (5.1 ± 1.4 vs. 4.1 ± 1.6, p = 0.01 and 6.2 ± 2.1 vs. 4.2 ± 1.5, p = 0.004, respectively). rTMS appears well tolerated and might be of interest for patients suffering from chronic pelvic pain for whom other treatments have failed. A randomized controlled trial is mandatory before proposing such treatment.

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Latin American and Caribbean consensus on noninvasive central nervous system neuromodulation for chronic pain management (LAC2-NIN-CP)

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 65 publications

References 117 publications

Alpha-phase synchrony EEG training for multi-resistant chronic low back pain patients: an open-label pilot study

Alpha-phase synchrony EEG training for multi-resistant chronic low back pain patients: an open-label pilot study

Differential Neuroplastic Changes in Fibromyalgia and Depression Indexed by Up-Regulation of Motor Cortex Inhibition and Disinhibition of the Descending Pain System: An Exploratory Study

Repetitive Transcranial Magnetic Stimulation Therapy (rTMS) for Endometriosis Patients with Refractory Pelvic Chronic Pain: A Pilot Study

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