Changes to somatosensory detection and pain thresholds following high frequency repetitive TMS of the motor cortex in individuals suffering from chronic pain

Abstract

Research has shown that transcranial magnetic stimulation (TMS) results in a transient reduction in the experience of chronic pain. The present research aimed to investigate whether a single session of high frequency TMS is able to change the sensory thresholds of individuals suffering from chronic pain. Detection and pain thresholds for cold and heat sensations were measured before and after 20Hz repetitive TMS (rTMS) administered over the motor cortex. A significant decrease in temperature for cold detection and pain thresholds and a significant increase in temperature for heat pain thresholds were evident following a single session of rTMS. In contrast, no change in detection and pain thresholds was obtained following sham rTMS. The finding that rTMS can have a direct effect on sensory thresholds in individuals suffering from chronic pain has implications for the therapeutic use of rTMS in the relief of chronic pain.

A Pilot Study of the Tolerability and Effects of High-Definition Transcranial Direct Current Stimulation (HD-tDCS) on Pain Perception

“…Similar studies using a different technology (transcranial magnetic stimulation; TMS) suggest that stimulation of the motor cortex is associated with changes in heat and cold sensory thresholds as well as heat and cold pain thresholds. 8,22,31 Using tDCS, Bachmann et al 3 found that cathodal stimulation over the motor cortex significantly impacted cold sensory, mechanical sensory, and mechanical pain thresholds in the contralateral hand. Bachmann et al found no significant effects for cold pain thresholds, pressure pain thresholds, or wind-up pain.…”

“…In the real stimulation group, 46% of participants guessed correctly (X 2 = .004, P = .94, ns) and in the sham group 18% guessed correctly (X 2 [1] = 2.23, P = .14, ns). The average guess-confidence rating was 5.50 (SD = 3.10) in the real HD-tDCS group and 4.55 (SD = 2.16) in the sham group (t [22] = .86, P = .399, ns).…”

“…4,21 TMS applied over the motor cortex has been shown to significantly impact chronic neuropathic pain and experimentally induced pain. 22,23,[28][29][30] TMS over the prefrontal cortex has been shown to affect pain perception in neuropathic pain, experimentally induced pain, fibromyalgia, and postoperative pain. 2,[9][10][11][12]39 However, TMS is more complicated than tDCS to deliver and may be associated with more risks, particularly the potential for causing a seizure.…”

Repetitive Transcranial Magnetic Stimulation (rTMS) in Experimentally Induced and Chronic Neuropathic Pain: A Review

“…1,8,9,[33][34][35][36] Generally, in these studies, clinically healthy participants were enlisted and were subjected to either ischemic muscle pain, 1 cold immersion, 33,36 capsaicin, 35 or laser-stimulated pain. 9,34 One study assessed whether sensory and pain thresholds were modifiable in patients with chronic back pain.…”

Non-pharmacological approach to neuropathic pain: the use of repetitive transcranial magnetic stimulation

“…Des données similaires ont été retrouvées chez des patients atteints de syndrome douloureux régional complexe de type I ayant reçu dix séances de SMTr à 10 Hz [41]. Johnson et al [17] ont évalué l'effet de la SMTr à 20 Hz chez des patients atteints de douleurs lombaires. Ils ont observé une réduction moyenne de 28 % de l'intensité douloureuse mesurée sur une EVA, qui était corrélée à un changement de la perception thermique au froid.…”