Motor cortex transcranial magnetic stimulation to reduce intractable postherpetic neuralgia with poor response to other threapies: Report of two cases

Wang, Huan; Hu, Yu-Zhong; Che, Xianwei; Yu, Liang

doi:10.12998/wjcc.v11.i9.2015

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…There was a slight chance to experience mild headache (5, 15, 10% in the M1, DLPFC, Sham group) and/or mild scalp discomfort (15, 20, 15% in the M1, DLPFC and Sham group), but three groups showed no difference and the sensations dissolved within minutes or hours. Overall, the treatments were safe and well-tolerated by this treatment protocol (Wang et al, 2023).…”

Section: Safety Assessmentmentioning

confidence: 83%

“…The M1 and DLPFC was located using the hotspot and Beam F3 methodology, respectively (Beam et al, 2009). The M1 target was contralateral to the painful side or corresponded to the left hemisphere in case of bilateral pain based on previous rTMS studies in analgesia (Lefaucheur et al, 2020;Attal et al, 2021;Wang et al, 2023). Meanwhile, the left DLPFC was stimulated according to most prior studies of pain (de Oliveira et al, 2014;Nardone et al, 2017;Cheng et al, 2023).…”

Section: Tms Treatmentmentioning

confidence: 99%

“…Transcranial magnetic stimulation (TMS) is a safe and noninvasive form of brain stimulation. Repetitive TMS (rTMS) is capable of inducing neuroplastic changes which has been proposed for the treatment of neuropathic pain (Lefaucheur et al, 2014(Lefaucheur et al, , 2020Wang et al, 2023). Only two studies have specifically investigated the effects on postherpetic neuralgia, with the results indicating a clear analgesic effect of high-frequency rTMS over the motor cortex (M1) (Ma et al, 2015;Pei et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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A randomised sham-controlled study evaluating rTMS analgesic efficacy for postherpetic neuralgia

Wang

Deng

et al. 2023

Front. Neurosci.

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ContextPostherpetic neuralgia (PHN) is a refractory neuropathic pain condition in which new treatment options are being developed. Repetitive transcranial magnetic stimulation (rTMS) may have the potential to reduce pain sensations in patients with postherpetic neuralgia.ObjectivesThis study investigated the efficacy on postherpetic neuralgia by stimulating two potential targets, the motor cortex (M1) and the dorsolateral prefrontal cortex (DLPFC).MethodsThis is a double-blind, randomised, sham-controlled study. Potential participants were recruited from Hangzhou First People’s Hospital. Patients were randomly assigned to either the M1, DLPFC or Sham group. Patients received ten daily sessions of 10-Hz rTMS in 2 consecutive weeks. The primary outcome measure was visual analogue scale (VAS) assessed at baseline, first week of treatment (week 1), post-treatment (week 2), 1-week (week 4), 1-month (week 6) and 3-month (week 14) follow-up.ResultsOf sixty patients enrolled, 51 received treatment and completed all outcome assessments. M1 stimulation resulted in a larger analgesia during and after treatment compared to the Sham (week 2 – week 14, p < 0.005), as well as to the DLPFC stimulation (week 1 – week 14, p < 0.05). In addition to pain, sleep disturbance was significantly improved and relieved by targeting either the M1 or the DLPFC (M1: week 4 – week 14, p < 0.01; DLPFC: week 4 – week 14, p < 0.01). Moreover, pain sensations following M1 stimulation uniquely predicted improvement in sleep quality.ConclusionM1 rTMS is superior to DLPFC stimulation in treating PHN with excellent pain response and long-term analgesia. Meanwhile, M1 and DLPFC stimulation were equally effective in improving sleep quality in PHN.Clinical trial registrationhttps://www.chictr.org.cn/, identifier ChiCTR2100051963.

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Section: Safety Assessmentmentioning

confidence: 83%

Section: Tms Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A randomised sham-controlled study evaluating rTMS analgesic efficacy for postherpetic neuralgia

Wang

Deng

et al. 2023

Front. Neurosci.

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Gabapentin/pregabalin

2023

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Effect of virtual reality combined with repetitive transcranial magnetic stimulation on musculoskeletal pain and motor development in children with spastic cerebral palsy: a protocol for a randomized controlled clinical trial

Li,

Huang,

et al. 2023

BMC Neurol

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Purpose This trial aims to investigate the efficacy and safety of virtual reality (VR) combined with repetitive transcranial magnetic stimulation (rTMS) for improving musculoskeletal pain and motor development in children with unilateral spastic cerebral palsy (CP). Methods This study protocol is for a randomized controlled trial consisting of 2 treatment sessions (3 days/week for 4 weeks in each session, with a 1-week interval between sessions). We will recruit children aged 3–10 years with unilateral spastic CP (Gross Motor Function Classification System level I or II). Participants will be randomly divided into 3 groups: the VR + rTMS group (immersive VR intervention, rTMS and routine rehabilitation therapy), rTMS group (rTMS and routine rehabilitation therapy), and control group (sham rTMS and routine rehabilitation therapy). VR therapy will involve a daily 40-minute movement training session in a fully immersive environment. rTMS will be applied at 1 Hz over the primary motor cortex for 20 min on the contralateral side. The stimulation intensity will be set at 90% of the resting motor threshold, with 1200 pulses applied. A daily 60-minute routine rehabilitation therapy session including motor training and training in activities of daily living will be administered to all participants. The primary outcome will be pain intensity, assessed by the Revised Face, Legs, Activity, Cry, and Consolability Scale (R-FLACC). The secondary outcomes will include motor development, evaluated by the 66-item version of the Gross Motor Function Measure (GMFM-66) and Fine Motor Function Measure (FMFM); balance capacity, measured by the interactive balance system; activities of daily living; and quality of life, measured by the Barthel index and the Chinese version of the Cerebral Palsy Quality of Life scale for Children (C-CP QOL-Child). Safety will be monitored, and adverse events will be recorded during and after treatment. Discussion Combined application of VR therapy and rTMS may reveal additive effects on pain management and motor development in children with spastic CP, but further high-quality research is needed. The results of this trial may indicate whether VR therapy combined with rTMS achieves a better analgesic effect and improves the motor development of children with spastic CP. Trial registration Registration number: ChiCTR230069853. Trial registration date: 28 March 2023. Prospectively registered.

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Motor cortex transcranial magnetic stimulation to reduce intractable postherpetic neuralgia with poor response to other threapies: Report of two cases

Cited by 3 publications

References 15 publications

A randomised sham-controlled study evaluating rTMS analgesic efficacy for postherpetic neuralgia

A randomised sham-controlled study evaluating rTMS analgesic efficacy for postherpetic neuralgia

Gabapentin/pregabalin

Effect of virtual reality combined with repetitive transcranial magnetic stimulation on musculoskeletal pain and motor development in children with spastic cerebral palsy: a protocol for a randomized controlled clinical trial

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