New updates on transcranial magnetic stimulation in chronic pain

Fernandes, Ana Mércia; Graven‐Nielsen, Thomas; Andrade, Daniel Ciampi de

doi:10.1097/spc.0000000000000591

Cited by 13 publications

(13 citation statements)

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“…She is currently inclined to try the former first. spinal cord, dorsal ganglion or the brain or externally, over the skin or scalp, as is the case of transcutaneous electric nervous stimulation (TENS) or transcranial direct current stimulation (tDCS) (Fernandes et al, 2022;Garcia-Larrea & Quesada, 2022). Such electric currents may also be induced indirectly, and painlessly, by a rapidly oscillating magnetic pulse, such as in transcranial magnetic stimulation (TMS).…”

Section: Panel 1: Case Vignettementioning

confidence: 99%

“…images, sounds or ultrasounds, electric currents) are delivered to the nervous system for therapeutic purposes (Moisset et al, 2020). The most used neuromodulatory agents are electric currents, which can be applied either directly upon nervous structures in the spinal cord, dorsal ganglion or the brain or externally, over the skin or scalp, as is the case of transcutaneous electric nervous stimulation (TENS) or transcranial direct current stimulation (tDCS) (Fernandes et al, 2022; Garcia‐Larrea & Quesada, 2022). Such electric currents may also be induced indirectly, and painlessly, by a rapidly oscillating magnetic pulse, such as in transcranial magnetic stimulation (TMS).…”

Section: Repetitive Transcranial Magnetic Stimulation For Pain: Why A...mentioning

confidence: 99%

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Beyond trial‐and‐error: Individualizing therapeutic transcranial neuromodulation for chronic pain

Ciampi de Andrade,

García‐Larrea

2023

European Journal of Pain

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Background and ObjectiveRepetitive transcranial magnetic stimulation (rTMS) applied to the motor cortex provides supplementary relief for some individuals with chronic pain who are refractory to pharmacological treatment. As rTMS slowly enters treatment guidelines for pain relief, its starts to be confronted with challenges long known to pharmacological approaches: efficacy at the group‐level does not grant pain relief for a particular patient. In this review, we present and discuss a series of ongoing attempts to overcome this therapeutic challenge in a personalized medicine framework.Databases and Data TreatmentRelevant scientific publications published in main databases such as PubMed and EMBASE from inception until March 2023 were systematically assessed, as well as a wide number of studies dedicated to the exploration of the mechanistic grounds of rTMS analgesic effects in humans, primates and rodents.ResultsThe main strategies reported to personalize cortical neuromodulation are: (i) the use of rTMS to predict individual response to implanted motor cortex stimulation; (ii) modifications of motor cortex stimulation patterns; (iii) stimulation of extra‐motor targets; (iv) assessment of individual cortical networks and rhythms to personalize treatment; (v) deep sensory phenotyping; (vi) personalization of location, precision and intensity of motor rTMS. All approaches except (i) have so far low or moderate levels of evidence.ConclusionsAlthough current evidence for most strategies under study remains at best moderate, the multiple mechanisms set up by cortical stimulation are an advantage over single‐target ‘clean’ drugs, as they can influence multiple pathophysiologic paths and offer multiple possibilities of individualization.SignificanceNon‐invasive neuromodulation is on the verge of personalised medicine. Strategies ranging from integration of detailed clinical phenotyping into treatment design to advanced patient neurophysiological characterisation are being actively explored and creating a framework for actual individualisation of care.

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Section: Panel 1: Case Vignettementioning

confidence: 99%

Section: Repetitive Transcranial Magnetic Stimulation For Pain: Why A...mentioning

confidence: 99%

Beyond trial‐and‐error: Individualizing therapeutic transcranial neuromodulation for chronic pain

Ciampi de Andrade,

García‐Larrea

2023

European Journal of Pain

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“…This probably shows that some investigators devote their work to understanding the impact of using TMS on the treatment of neuropathic pain, evaluating the resulting outcomes and understanding the impact of using TMS in the treatment of different types of neuropathic pain, such as neuralgia [ 31 ]. In fact, there are studies that suggest that TMS is a reasonable and well-tolerated add-on treatment in neuropathic pain [ 32 , 33 , 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Transcranial Magnetic Stimulation to Treat Neuropathic Pain: A Bibliometric Analysis

Carneiro,

Tavares

2024

Healthcare

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Neuropathic pain is caused by a lesion or disease of the somatosensory system and is one of the most incapacitating pain types, representing a significant non-met medical need. Due to the increase in research in the field and since innovative therapeutic strategies are required, namely in intractable neuropathic pain, neurostimulation has been used. Within this approach, transcranial magnetic stimulation (TMS) that uses a transient magnetic field to produce electrical currents over the cortex emerges as a popular method in the literature. Since this is an area in expansion and due to the putative role of TMS, we performed a bibliometric analysis in Scopus with the primary objective of identifying the scientific production related to the use of TMS to manage neuropathic pain. The research had no restrictions, and the analysis focused on the characteristics of the literature retrieved, scientific collaboration and main research topics from inception to 6 July 2023. A total of 474 articles were collected. A biggest co-occurrence between the terms “neuropathic pain” and “transcranial magnetic stimulation” was obtained. The journal “Clinical Neurophysiology” leads the Top 5 most productive sources. The United States is the most productive country, with 50% of US documents being “review articles”, followed by France, with 56% of French documents being “original articles”. Lefaucheur, JP and Saitoh, Y are the two most influential authors. The most frequent type of document was “original article”. Most of the studies (34%) that identified the neuropathic pain type focused on traumatic neuropathic pain, although a large proportion (38%) did not report the neuropathic pain type. This study allows us to provide a general overview of the field of TMS application for neuropathic pain and is useful for establishing future directions of research in this field.

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“…Further research could delve into novel neuroimaging techniques, like high-resolution functional Magnetic Resonance Imaging (fMRI) [128,129], and innovative non-invasive neuromodulation methods, such as transcranial direct current stimulation (tDCS) [130] or transcranial magnetic stimulation (TMS) [131,132]. These tools can provide more detailed insights into the brain's response to pain stimuli in DOC patients.…”

Section: Discussionmentioning

confidence: 99%

I Feel! Therefore, I Am from Pain to Consciousness in DOC Patients

Riganello

Tonin

Soddu

2023

IJMS

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Pain assessment and management in patients with disorders of consciousness (DOC) is a challenging and important aspect of care, with implications for detecting consciousness and promoting recovery. This narrative review explores the role of pain in consciousness, the challenges of pain assessment, pharmacological treatment in DOC, and the implications of pain assessment when detecting changes in consciousness. The review discusses the Nociception Coma Scale and its revised version, which are behavioral scales used to assess pain in DOC patients, and the challenges and controversies surrounding the appropriate pharmacological treatment of pain in these patients. Moreover, we highlight recent evidence suggesting that an accurate pain assessment may predict changes in the level of consciousness in unresponsive wakefulness syndrome/vegetative state patients, underscoring the importance of ongoing pain management in these patients.

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New updates on transcranial magnetic stimulation in chronic pain

Cited by 13 publications

References 71 publications

Beyond trial‐and‐error: Individualizing therapeutic transcranial neuromodulation for chronic pain

Beyond trial‐and‐error: Individualizing therapeutic transcranial neuromodulation for chronic pain

Transcranial Magnetic Stimulation to Treat Neuropathic Pain: A Bibliometric Analysis

I Feel! Therefore, I Am from Pain to Consciousness in DOC Patients

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