Neuromodulation Management of Chronic Neuropathic Pain in the Central Nervous System

Yu, Kai; He, Bin; He, Bin

doi:10.1002/adfm.201908999

Cited by 50 publications

(32 citation statements)

References 234 publications

(281 reference statements)

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“…In the search for therapeutic options for patients with chronic pain management, Transcranial Magnetic Stimulation Therapy (rTMS) emerges as an innovative alternative, which is a non-invasive, safe, and painless neurophysiological technique which induce electrical currents in the nervous tissue of the cortex (19). The analgesic effect begins with stimulation of the primary motor cortex (M1) (20).…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Effectiveness of transcranial magnetic stimulation in the management of oncological and non-oncological neuropathic pain. A systematic review

Muñetón

Bedoya

Bustos

et al. 2022

Preprint

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Purpose: Transcranial Magnetic Stimulation (rTMS) emerges as an innovative alternative for the management of neuropathic pain, rTMS is a non-invasive brain stimulation technique which induces electrical currents in the nervous tissue of the cortex. The objective of this study was to evaluate the effectiveness of rTMS in the management of oncological and non- oncological neuropathic pain. Methods: The search was performed in CENTRAL, MEDLINE, Embase, PsycINFO, SCOPUS and LILACS. Inclusion criteria were 1) population: Male and female between 18 and 85 years with oncologic and non-oncologic neuropathic pain; 2) intervention: Treated with Transcranial magnetic stimulation; 3) comparison: Inactive control groups, and parallel active interventions; and 4) outcome: Primary outcome was modulation of pain. Secondary outcomes were quality of life and adverse effects. Risk of bias and quality of study reporting were also assessed. Results: The search found 1116 articles, with 18 articles meeting the PICO criteria. 9 ECAS and 9 observational studies. The total sample was 707 patients, the number of sessions ranges from a single session to 15 sessions, with an average of 3.5 sessions. Follow-up was variable. The Follow-up vary from 7 to 311.8 days, with an average of 45 days. Pain reduction was obtained in the 18 studies. Conclusion: rTMS may be and effective therapeutic option to treat neuropathic pain. We found moderate quality of evidence for pain modulation; for quality of life the results are uncertain to determine changes, due to very low evidence. Additional research effort is needed to reduce bias and improve quality.

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Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Effectiveness of transcranial magnetic stimulation in the management of oncological and non-oncological neuropathic pain. A systematic review

Muñetón

Bedoya

Bustos

et al. 2022

Preprint

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“…Given the importance of the MRCP in the scientific investigations on healthy human subjects [29] and clinical evaluations on patients diagnosed with functional motor disorders, such as Parkinson's disease and amyotrophic lateral sclerosis (ALS) [46], it would be valuable to have a noninvasive neuroimaging tool, such as ESI, to map and quantify the MRCP source at specific brain circuits with high spatiotemporal resolution, thus informing the non-invasive neuromodulation for guidance and feedback [47]. Electrophysiological source imaging has been pursued to localize and image brain electrical sources from noninvasive scalp recorded EEG/ Magnetoencephalography (MEG), and demonstrated to provide greatly enhanced spatial resolution than the raw EEG/MEG in many applications [30,31,48].…”

Section: Discussionmentioning

confidence: 99%

Transcranial Focused Ultrasound Neuromodulation of Voluntary Movement-Related Cortical Activity in Humans

Yu¹,

Liu²,

Niu³

et al. 2021

IEEE Trans. Biomed. Eng.

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Transcranial focused ultrasound (tFUS) is an emerging non-invasive brain stimulation tool for safely and reversibly modulating brain circuits. The effectiveness of tFUS on human brain has been demonstrated, but how tFUS influences the human voluntary motor processing in the brain remains unclear. Methods: We apply low-intensity tFUS to modulate the movement-related cortical potential (MRCP) originating from human subjects practicing a voluntary foot tapping task. 64channel electroencephalograph (EEG) is recorded concurrently and further used to reconstruct the brain source activity specifically at the primary leg motor cortical area using the electrophysiological source imaging (ESI). Results: The ESI illustrates the ultrasound modulated MRCP source dynamics with high spatiotemporal resolutions. The MRCP source is imaged and its source profile is further evaluated for assessing the tFUS neuromodulatory effects on the voluntary MRCP. Moreover, the effect of ultrasound pulse repetition frequency (UPRF) is further assessed in modulating the MRCP. The ESI results show that tFUS significantly increases the MRCP source profile amplitude (MSPA) comparing to a sham ultrasound condition, and further, a high UPRF enhances the MSPA more than a low UPRF does. Conclusion: The present results demonstrate the neuromodulatory effects of the low-intensity tFUS on enhancing the human voluntary movement-related cortical activities evidenced through the ESI imaging. Significance: This work provides the first evidence of tFUS enhancing the human endogenous motor cortical activities through excitatory modulation.

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“…Currently, such treatment options are limited to patients who do not respond to pharmacological treatments or have preexisting comorbidities that render pharmacological treatment at risk [41]. e main noninvasive brain stimulation techniques that showed a benefit in the treatment of neuropathic pain are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS).…”

Section: Noninvasive Neurostimulationmentioning

confidence: 99%

Focused Ultrasound (FUS) for Chronic Pain Management: Approved and Potential Applications

Biase

Falato

Caminiti

et al. 2021

Neurology Research International

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Chronic pain is one of the leading causes of disability and disease burden worldwide, accounting for a prevalence between 6.9% and 10% in the general population. Pharmacotherapy alone results ineffective in about 70-60% of patients in terms of a satisfactory degree of pain relief. Focused ultrasound is a promising tool for chronic pain management, being approved for thalamotomy in chronic neuropathic pain and for bone metastases-related pain treatment. FUS is a noninvasive technique for neuromodulation and for tissue ablation that can be applied to several tissues. Transcranial FUS (tFUS) can lead to opposite biological effects, depending on stimulation parameters: from reversible neural activity facilitation or suppression (low-intensity, low-frequency ultrasound, LILFUS) to irreversible tissue ablation (high-intensity focused ultrasounds, HIFU). HIFU is approved for thalamotomy in neuropathic pain at the central nervous system level and for the treatment of facet joint osteoarthritis at the peripheral level. Potential applications include HIFU at the spinal cord level for selected cases of refractory chronic neuropathic pain, knee osteoarthritis, sacroiliac joint disease, intervertebral disc nucleolysis, phantom limb, and ablation of peripheral nerves. FUS at nonablative dosage, LILFUS, has potential reversible and tissue-selective effects. FUS applications at nonablative doses currently are at a research stage. The main potential applications include targeted drug and gene delivery through the Blood-Brain Barrier, assessment of pain thresholds and study of pain, and reversible peripheral nerve conduction block. The aim of the present review is to describe the approved and potential applications of the focused ultrasound technology in the field of chronic pain management.

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Neuromodulation Management of Chronic Neuropathic Pain in the Central Nervous System

Cited by 50 publications

References 234 publications

WITHDRAWN: Effectiveness of transcranial magnetic stimulation in the management of oncological and non-oncological neuropathic pain. A systematic review

WITHDRAWN: Effectiveness of transcranial magnetic stimulation in the management of oncological and non-oncological neuropathic pain. A systematic review

Transcranial Focused Ultrasound Neuromodulation of Voluntary Movement-Related Cortical Activity in Humans

Focused Ultrasound (FUS) for Chronic Pain Management: Approved and Potential Applications

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