The mechanism and effect of repetitive transcranial magnetic stimulation for post-stroke pain

Abstract

Post-stroke pain (PSP) is a common complication after stroke and affects patients' quality of life. Currently, drug therapy and non-invasive brain stimulation are common treatments for PSP. Given the poor efficacy of drug therapy and various side effects, non-invasive brain stimulation, such as repetitive transcranial magnetic stimulation (rTMS), has been accepted by many patients and attracted the attention of many researchers because of its non-invasive and painless nature. This article reviews the therapeutic effect of rTMS on PSP and discusses the possible mechanisms. In general, rTMS has a good therapeutic effect on PSP. Possible mechanisms of its analgesia include altering cortical excitability and synaptic plasticity, modulating the release of related neurotransmitters, and affecting the structural and functional connectivity of brain regions involved in pain processing and modulation. At present, studies on the mechanism of rTMS in the treatment of PSP are lacking, so we hope this review can provide a theoretical basis for future mechanism studies.

Non-Invasive Electric and Magnetic Brain Stimulation for the Treatment of Fibromyalgia

“…Although non-invasive brain stimulation appears to be effective for the treatment of fibromyalgia, rTMS and tDCS effects might not be specific to the symptoms of this pathology. Thus, rTMS protocols described in clinical fibromyalgia studies have shown similar effectiveness for relieving rheumatic [ 101 , 102 ] and post-stroke [ 103 ] pain. Likewise, the therapeutic effects of electric brain stimulation also do not seem to be restricted to fibromyalgia, as pain improvements after tDCS interventions have been described in patients with different pain syndromes (trigeminal neuralgia, poststroke pain syndrome, back pain, and fibromyalgia) [ 104 ].…”

High-Frequency Repetitive Transcranial Magnetic Stimulation (HF-rTMS) on Overall Cognition in patients with Post-Stroke Cognitive Impairment: A Systematic Review and Meta-analysis

“…Figure 2 showed the results of the risk-of-bias evaluations. Randomized grouping was judged to be "high risk" because odd and even numbers were used in one study, 50 and 35 studies [14][15][16][18][19][20][21][22][23][24][25][26]29,30,32,33,[35][36][37][38]41,42,[44][45][46]48,49,52,57,59,60,64,66,68,69 were judged as "low risk." Regarding allocation concealment, three studies 29,37,59 that reported the allocation concealment method were judged as "low risk."…”

“…Of these 61 studies, a total of 28 studies 14,[18][19][20][21][23][24][25][30][31][32]34,35,37,[39][40][41]47,49,51,52,54,57,59,66,69,73,74 used a frequency of 10 Hz for HF-rTMS, 13 studies 15,22,26,29,33,38,44,45,61,65,67,68,71 used 5 Hz, and the others used 2-50 Hz. The resting motor threshold (MT) is the minimum intensity of TMS stimulation of a fully relaxed muscle that elicits an electromyograph response of at least 50 μV with a probability of 50%.…”

“…The resting motor threshold (MT) is the minimum intensity of TMS stimulation of a fully relaxed muscle that elicits an electromyograph response of at least 50 μV with a probability of 50%. A total of 52 studies [14][15][16][17][18][19][21][22][23][24][25][26][27][29][30][31][32][33][34][35][36]38,39,41,42,44,45,[47][48][49][50][52][53][54][55][56][57][59][60][61][62][63][64][65][66][67][68][69][70][71]73,…”

“…A total of 52 studies [14][15][16][17][18][19][21][22][23][24][25][26][27][29][30][31][32][33][34][35][36]38,39,41,42,44,45,[47][48][49][50][52][53][54][55][56][57][59][60][61][62][63][64][65][66][67][68][69][70][71]73,74 had HF-rTMS stimulation intensities ranging from 80%MT to 120%MT, two studies…”