Effect of Deep Intramuscular Stimulation and Transcranial Magnetic Stimulation on Neurophysiological Biomarkers in Chronic Myofascial Pain Syndrome

Medeiros, Liciane Fernandes; Caumo, Wolnei; Dussán‐Sarria, Jairo Alberto; Deitos, Alícia; Brietzke, Aline Patrícia; Laste, Gabriela; Carraro, Cristina Campos; Souza, Andressa de; Scarabelot, Vanessa Leal; Cioato, Stefânia Giotti; Vercelino, Rafael; Castro, Alexandre Luz de; Araújo, Alex Sander da Rosa; Belló‐Klein, Adriane; Fregni, Felipe; Torres, Iraci Lucena da Silva

doi:10.1111/pme.12919

Cited by 14 publications

(42 citation statements)

References 92 publications

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“…Numerous therapeutic approaches are used to treat MPS, including education, acupuncture, massage, ultrasonography, electrotherapy, dry needling, drugs, and physiotherapy rehabilitative treatments (124). As chronic pain caused by MPS is induced by central and peripheral sensitization, a neuromodulatory technique, including rTMS, may aid in modulating this sensitization process by reverting the associated defective inhibitory systems (99).…”

Section: Myofascial Pain Syndromementioning

confidence: 99%

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Effect of Repetitive Transcranial Magnetic Stimulation on Pain Management: A Systematic Narrative Review

Yang

Lee

2020

Front. Neurol.

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Recently, clinicians have been using repetitive transcranial magnetic stimulation (rTMS) for treating various pain conditions. This systematic narrative review aimed to examine the use and efficacy of rTMS for controlling various pain conditions. A PubMed search was conducted for articles that were published until June 7, 2019 and used rTMS for pain alleviation. The key search phrase for identifying potentially relevant articles was (repetitive transcranial magnetic stimulation AND pain). The following inclusion criteria were applied for article selection: (1) patients with pain, (2) rTMS was applied for pain management, and (3) follow-up evaluations were performed after rTMS stimulation to assess the reduction in pain. Review articles were excluded. Overall, 1,030 potentially relevant articles were identified. After reading the titles and abstracts and assessing eligibility based on the full-text articles, 106 publications were finally included in our analysis. Overall, our findings suggested that rTMS is beneficial for treating neuropathic pain of various origins, such as central pain, pain from peripheral nerve disorders, fibromyalgia, and migraine. Although data on the use of rTMS for orofacial pain, including trigeminal neuralgia, phantom pain, low back pain, myofascial pain syndrome, pelvic pain, and complex regional pain syndrome, were promising, there was insufficient evidence to determine the efficacy of rTMS for treating these conditions. Therefore, further studies are needed to validate the effects of rTMS on pain relief in these conditions. Overall, this review will help guide clinicians in making informed decisions regarding whether rTMS is an appropriate option for managing various pain conditions.

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Section: Myofascial Pain Syndromementioning

confidence: 99%

“…Two RCTs (98,99) have investigated the effect of rTMS on patients with MPS. In 2014, Dall'Agnol et al (98) applied 10 sessions of rTMS treatment to 24 patients who were diagnosed with MPS in an upper body segment for at least 3 months (12 patient received real rTMS, and the remaining 12 received sham rTMS).…”

Section: Myofascial Pain Syndromementioning

confidence: 99%

Effect of Repetitive Transcranial Magnetic Stimulation on Pain Management: A Systematic Narrative Review

Yang

Lee

2020

Front. Neurol.

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“…The average of 10 sequential measures of MEP/CSP-rectified traces was then recorded, which makes it possible to visualize the voluntary EMG activity level at baseline (i.e., prior to the TMS pulse). Thus, the cessation of the CSP can be demarcated more precisely by the return of voluntary EMG activity relative to the tonic baseline EMG level, as the second method described by Rossini ( 20 , 23 ).…”

Section: Methodsmentioning

confidence: 99%

Longer Cortical Silent Period Length Is Associated to Binge Eating Disorder: An Exploratory Study

et al. 2020

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Introduction: Although binge eating disorder (BED) is an eating disorder and obesity is a clinical disease, it is known that both conditions present overlapped symptoms related to, at least partially, the disruption of homeostatic and hedonistic eating behavior pathways. Therefore, the understanding of neural substrates, such as the motor cortex excitability assessed by transcranial magnetic stimulation (TMS), might provide new insights into the pathophysiology of BED and obesity. Objectives: (i) To compare, among BED, obesity, ex-obese, and HC (healthy control) subjects, the cortical excitability indexed by TMS measures, such as CSP (cortical silent period; primary outcome), SICI (intracortical inhibition), and ICF (intracortical facilitation; secondary outcome). (ii) To explore the relationship of the CSP, eating behavior (e.g., restraint, disinhibition, and hunger), depressive symptoms, and sleep quality among the four groups (BED, obesity, ex-obese, and HC). Methods: Fifty-nine women [BED ( n = 13), obese ( n = 20), ex-obese ( n = 12), and HC ( n = 14)] comprise the total sample for this study. Assessments: cortical excitability measures (CSP, SICI, and ICF), inhibition response task by the Go/No-go paradigm, and instruments to assess the eating psychopathology (Three-Factor Eating Questionnaire, Eating Disorder Examination Questionnaire, and Binge Eating Scale) were used. Results: A MANCOVA analysis revealed that the mean of CSP was longer in the BED group compared with other three groups: 24.10% longer than the obesity group, 25.98% longer than the HC group, and 25.41% longer than the ex-obese group. Pearson's correlations evidenced that CSP was positively associated with both eating concern and binge eating scores. Conclusion: The findings point out that BED patients present longer CSP, which might suggest an upregulation of intracortical inhibition. Additionally, CSP was positively correlated with Binge Eating Scale and eating concern scores. Further studies are needed.

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“…Prolonged muscle contraction, ischemia/hypoxia, metabolic disorders, and cell stress also lead to increased release of neurotransmitters, inflammatory cytokines, and myokines, which necessary in the pathophysiology of myofascial pain [2,25,31]. Damage to these muscles cause the release of neuropeptides, cytokines, and inflammatory substances such as potassium, bradykinin, cytokines, tumor necrosis factor, interleukin 1β, norepinephrine, protons, prostaglandins, ATP and substances P that can stimulate nociceptors in the muscle thereby releasing CGRP (calcitonin gene-related peptide) [2,8,9,15,18,25].…”

Section: Role Of Inflammation In Pathophysiology Of Myofascial Painmentioning

confidence: 99%

The role of oxidative stress, inflammation and glial cell in pathophysiology of myofascial pain

Widyadharma¹

2020

ppn

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Purpose: The aim of this article is to explain the role of oxidative stress, inflammatory responses, and glial cell in the pathophysiology of myofascial pain. Therefore the management of myofascial pain can be optimally done by clinicians through blockage of each biomarker in a specific pathway. Views: Myofascial pain is often one of the reasons for patients to visit the doctor with a prevalence of approximately 21-30%. Overused muscle can lead to myofascial trigger points. Activities that cause ongoing muscle contraction can cause an increase in metabolic stress and decreased blood flow resulting in the imbalance of oxidative-antioxidant. Malondialdehyde is one of the biomarkers of oxidative stress. This process also can increase the release of neuropeptides, cytokines, and inflammatory substances. Prostaglandins, especially prostaglandin E2 (PGE2), can increase vascular permeability and cell proliferation that binds to sensory neuron receptors, which facilitate sensitization to the pain nerve. Astrocytes are the most abundant cell type in the central nervous system, which plays an essential role in the induction and persistence of pain. In ischemic conditions, astrocytes will alternate and turn into reactive astrogliosis. This condition will increase the level of glial fibrillary acidic protein. Conclusions: The exact pathophysiology of myofascial pain is not thoroughly clear. Hence, some studies found the total levels of oxidative stress were higher in patients with myofascial pain. Malondialdehyde, PGE2, and GFAP as the biomarkers from those factors are increased in patients with myofascial pain.

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Effect of Deep Intramuscular Stimulation and Transcranial Magnetic Stimulation on Neurophysiological Biomarkers in Chronic Myofascial Pain Syndrome

Cited by 14 publications

References 92 publications

Effect of Repetitive Transcranial Magnetic Stimulation on Pain Management: A Systematic Narrative Review

Effect of Repetitive Transcranial Magnetic Stimulation on Pain Management: A Systematic Narrative Review

Longer Cortical Silent Period Length Is Associated to Binge Eating Disorder: An Exploratory Study

The role of oxidative stress, inflammation and glial cell in pathophysiology of myofascial pain

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