Motor cortex rTMS reduces acute pain provoked by laser stimulation in patients with chronic neuropathic pain

No Effect of a Single Session of Transcranial Direct Current Stimulation on Experimentally Induced Pain in Patients with Chronic Low Back Pain – An Exploratory Study

“…These results differ from those reported in two other studies on the effects of repetitive transcranial magnetic stimulation (rTMS) on experimental pain in patients suffering from a chronic pain condition [25], [26]. rTMS is a different type of non-invasive brain stimulation that uses a transient magnetic field to elicit electrical currents in the stimulated area that - not unlike tDCS- modulate cortical excitability and subsequently in a top-down order a network of structures crucial to nociception [53].…”

“…Therefore, our findings should be interpreted with caution: WDT were increased both after cathodal and anodal stimulation in our sample. As this is contrary to a concept of diametrically opposed neurophysiological effects of anodal and cathodal stimulation on cortical excitability [1], our findings are difficult to explain and may be due to unspecific effects such as a decline of attention during the sessions – an effect also observed in the study of Lefaucheur and colleagues [25]. The fact that we examined statistically significant main effects and interactions by uncorrected post hoc tests supports a careful appraisal of these findings.…”

“…As chronic noxious input causes widespread structural changes to the brain [18], [19], [20] and extensive functional changes to the nociceptive system [21], [22], [23], [24], it is tempting to speculate that effects of tDCS could be more pronounced in patients with chronic pain compared to healthy participants. However, to date this has only been examined in repetitive transcranial magnetic brain stimulation (rTMS) of the motor cortex: a recent study has shown an attenuation of experimental hand pain in chronic neuropathic pain [25]. Another study on patients with chronic back pain demonstrated a modulation of sensory thresholds after rTMS measured at the contralateral hand [26].…”

High-resolution functional magnetic resonance imaging mapping of noxious heat and tactile activations along the central sulcus in New World monkeys

“…In chronic neuropathic pain patients, stimulation of M1 cortex show promising analgesia effects [26]. Similarly transcranial magnetic and electrical stimulation of motor cortex can apparently reduce intractable central pain [10, 51], complex regional pain syndrome, reviews see [1, 58], neuropathic pain [27, 29, 30, 35, 47, 50, 53], thalamic pain [57], and experimental pain [46]. These studies support an inhibitory interaction between sensory and motor areas.…”

Transcranial Magnetic Stimulation for Chronic Pain

“…69 Numerous studies have reported the efficacy of rTMS (10 Hz) of the M1 in relieving chronic pain related to thalamic/brainstem stroke, trigeminal nerve, brachial plexus, nerve trunk, and spinal cord lesions compared with sham stimulation. 17,36,[70][71][72][73] One of the studies reported that rTMS is more effective when applied to an area adjacent to the cortical representation of the painful zone compared with stimulation of the motor cortex corresponding with the painful area (facial pain improved instead of hand pain when the hand motor cortical area was stimulated). 71 Pleger and colleagues 74 reported transient pain relief in 70% of patients (7 of 10 patients) with complex regional pain syndrome following rTMS (10 Hz) of the motor cortex, with maximum benefits being observed 15 minutes after stimulation.…”