Long-term antalgic effects of repetitive transcranial magnetic stimulation of motor cortex and serum beta-endorphin in patients with phantom pain

Ahmed, Mohamed A.; Mohamed, Sahar Abdel-Baky; Sayed, Douaa

doi:10.1179/1743132811y.0000000045

Cited by 114 publications

(112 citation statements)

References 30 publications

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“…Upregulation of motor cortex excitability might therefore modulate pain perception through indirect effects on neural networks in pain-modulating areas, such as thalamic nuclei, as suggested by neuroimaging [5]. The effect on pain may also be mediated by changes in beta-endorphin levels, which have been reported to be increased after repetitive transcranial magnetic stimulation (rTMS) as measured directly in serum as in the studies of de Andrade et al [8] and Ahmed et al [9] or indirectly as in the study of Taylor et al [10] who found that naloxone pretreatment could reduce the analgesic effect of rTMS, consistent with involvement of beta-endorphin.…”

Section: Introductionmentioning

confidence: 80%

“…Töpper et al [31] found that the opiate antagonist naloxone abolished the rTMS-induced pain relief, which was taken as an evidence that the analgesic effect of rTMS acted via the release of endorphins. Ahmed et al [9] found an elevation of serum beta-endorphin concentration after five sessions of 20 Hz rTMS over the left-hand area of motor cortex in 17 patients with chronic phantom pain. However, serum human Dyn level was measured in the present study and we found that there was no significant interaction between real and sham groups in tested patients with visceral pain.…”

Section: Discussionmentioning

confidence: 99%

“…The present study is an indicator for the first time that rTMS of motor cortex may also be effective in patients with malignant visceral pain due to different pathology. The rationale to choose 10 sessions of rTMS in order to obtain more sustained pain relieve was for that most of the previous studies found that repeated sessions have a cumulative and long-term effect on relieving pain [9,27,28].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of Repetitive Transcranial Magnetic Stimulation on Malignant Visceral Pain

Khedr¹,

Mostafa²,

Kotb³

et al. 2015

Neuroenterology

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Background and objectives. To assess the efficacy of 10 sessions (once daily for 10 days) of repetitive transcranial magnetic stimulation (rTMS) on primary motor cortex (M1) in patients suffering from malignant visceral pain. Materials and methods. Thirty four patients were included in the study. They were divided randomly into two groups (17 patients for each, using closed envelopes): real rTMS (20 Hz, 10 trains with intertrain interval of 30 s with total pulses 2,000, intensity 80% of motor threshold) and sham rTMS (coil elevated and angled away from the head). Stimulation was applied over M1 every day for ten consecutive days. Patients were evaluated using a verbal descriptor scale (VDS), visual analog scale (VAS), and Hamilton rating scale for depression (HAM-D) at baseline; after the 1st, 5th, and 10th sessions; and then at 15 days and one month later after the end of the treatment sessions. Serum human dynorphin (Dyn) was measured at baseline, and after the 5th and 10th sessions. Results. Fifteen patients from each group completed the study. There was no significant difference between real and sham groups in the duration of illness, or any rating scales at baseline. Compared with the sham group, the VAS/VDS scores decreased more in patients who received real rTMS over the course of the treatment and at 15 days follow-up than in those who received sham stimulation. Scores were the same at one month follow-up. There were no significant changes in serum human Dyn in either group. Conclusion. The results confirm that 10 sessions of rTMS over the M1 can induce pain relief in malignant visceral pain for at least 15 days but the effect is not maintained at one month.

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Section: Introductionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Repetitive Transcranial Magnetic Stimulation on Malignant Visceral Pain

Khedr¹,

Mostafa²,

Kotb³

et al. 2015

Neuroenterology

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“…При этом в некоторых работах проводился толь-ко один сеанс рТМС, и обезболивающее действие оцени-вали непосредственно после стимуляции [73-75, 79, 82-86]. Однако более важным результатом является доказа-тельство долговременного обезболивающего эффекта не-скольких последовательных сеансов рТМС при хрониче-ских нейропатических болях различной этиологии [87,88] и фантомных болях [89].…”

Section: болевые синдромыunclassified

Repetitive transcranial magnetic stimulation in neurology and psychiatry

Chervyakov

Poydasheva

Korzhova

et al. 2015

Z. nevrol. psikhiatr. im. S.S. Korsakova

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“…Эффект сохранялся в течение 3 нед после завершения лечения [24]. Имеются данные о том, что эффективность использования ТКМС в лече-нии боли может быть связана с повышением содер-жания β-эндорфинов в сыворотке крови [25].…”

Section: воздействие магнитным полем: -транскраниальная магнитная стиunclassified

The neurophysiological basis of the effectiveness of transcranial methods for the treatment of neuropathic pain

Razumov¹,

Ea²

2015

Vopr. kurortol. fizioter. lech. fiz. kul't.

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Хронический болевой синдром является рас-пространенной причиной дезадаптации и снижения качества жизни пациентов, вызывая необходимость в частых визитах к врачу, повторных курсах стацио-нарного или амбулаторного лечения, постоянном приеме обезболивающих препаратов. По данным Российского исследования EPIC, жалобы на боль являются причиной обращения к неврологу в 39% случаев [1].Выделяют острую (ноцицептивную) и хрониче-скую (невропатическую) боль, которые различают-ся по этиопатогенезу и условиям возникновения. Ноцицептивная боль возникает при нарушении це-лостности тканей в ответ на травматическое по-вреждение или воспаление. В этих случаях боль мо-жет продолжаться весь период заживления, форми-рования рубца или восстановления тканей. Сведения об авторах:Разумов Александр Николаевич -академик РАН, д.м.н., проф., ди-ректор МНПЦ МРВСМ, e-mail: a-razumov@mail.ru; Мельникова Екатерина Александровна -к.м.н., рук. отд. реабилитации боль-ных с заболеваниями нервной системы МНПЦ МРВСМ, e-mail: melkaterina3@yandex.ru В статье приведены данные о распространенности хронических болевых синдромов в клинической практике. Показана актуальность проблемы поиска эффективных методов лечения таких больных. Проанализированы механизмы развития невропатической боли. Приведены возможные патогенетически обоснованные пути фармакологической и немедикамен-тозной коррекции хронической боли. Освещены результаты последних метаанализов сравнительной эффективности транскраниальных методов. Обозначены направления дальнейших исследований в области монотерапии и комбинирован-ного лечения невропатической боли. Ключевые слова: невропатическая боль, транскраниальная электростимуляция, транскраниальная магнитная стимуляция.The present article reports the data concerning the prevalence of chronic pain syndromes in clinical practice. The importance of addressing the problem of finding effective treatment modalities for the patients presenting with these conditions is emphasized. The mechanisms of neuropathic pain are analyzed. The possible pathogenetically sound substantiations for the pharmacological and non-pharmacological treatment of chronic pain are discussed. The article highlights the results of recent meta-analyses of the comparative effectiveness of transcranial methods. The mail lines of further investigations in the field of monotherapy and combined treatment of neuropathic pain are outlined.

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Long-term antalgic effects of repetitive transcranial magnetic stimulation of motor cortex and serum beta-endorphin in patients with phantom pain

Abstract: These results confirm that five daily sessions of rTMS over motor cortex can produce long lasting pain relief in patients with phantom pain and it might be related to an elevation of serum beta-endorphin concentration.

Cited by 114 publications

References 30 publications

Effect of Repetitive Transcranial Magnetic Stimulation on Malignant Visceral Pain

Effect of Repetitive Transcranial Magnetic Stimulation on Malignant Visceral Pain

Repetitive transcranial magnetic stimulation in neurology and psychiatry

The neurophysiological basis of the effectiveness of transcranial methods for the treatment of neuropathic pain

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