Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) during capsaicin-induced pain: modulatory effects on motor cortex excitability

Fierro, Brigida; Tommaso, Marina de; Giglia, Francesca; Giglia, Giuseppe; Palermo, Antonio; Brighina, Filippo

doi:10.1007/s00221-010-2206-6

Cited by 121 publications

(129 citation statements)

References 41 publications

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“…If recovery of DLPFC thickness and/or function is necessary for pain relief, then the DLPFC may be a target for treatment. In fact, it has already shown some promise in studies of short-and longterm analgesia from repetitive transcranial magnetic stimulation (rTMS) of the prefrontal cortex (Reid and Pridmore, 2001;Brighina et al, 2004;Graff-Guerrero et al, 2005;Avery et al, 2007;Borckardt et al, 2007Borckardt et al, , 2008Nahmias et al, 2009;Fierro et al, 2010). Interestingly, similar to treating depression with rTMS (Brunelin et al, 2007), these rTMS studies in pain seem to show a preferential effect for left-sided stimulation, the side that changed in the present study.…”

Section: Future Directionssupporting

confidence: 53%

“…Several studies have also indicated abnormal cortical function in people with CLBP (Giesecke et al, 2004;Baliki et al, 2008;Lloyd et al, 2008;Kobayashi et al, 2009;Tagliazucchi et al, 2010). Evidence from pain neuroimaging and transcranial magnetic stimulation studies has linked the DLPFC to pain modulation (Lorenz et al, 2003;Brighina et al, 2004;Fierro et al, 2010), placebo analgesia (Wager et al, 2004;Krummenacher et al, 2010), perceived control of pain (Pariente et al, 2005;Wiech et al, 2006), and pain catastrophizing (Seminowicz and Davis, 2006).…”

Section: Introductionmentioning

confidence: 99%

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Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function

et al. 2011

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Chronic pain is associated with reduced brain gray matter and impaired cognitive ability. In this longitudinal study, we assessed whether neuroanatomical and functional abnormalities were reversible and dependent on treatment outcomes. We acquired MRI scans from chronic low back pain (CLBP) patients before (n ϭ 18) and 6 months after (spine surgery or facet joint injections; n ϭ 14) treatment. In addition, we scanned 16 healthy controls, 10 of which returned 6 months after the first visit. We performed cortical thickness analysis on structural MRI scans, and subjects performed a cognitive task during the functional MRI. We compared patients and controls, as well as patients before versus after treatment. After treatment, patients had increased cortical thickness in the left dorsolateral prefrontal cortex (DLPFC), which was thinner before treatment compared with controls. Increased DLPFC thickness correlated with the reduction of both pain and physical disability. Additionally, increased thickness in primary motor cortex was associated specifically with reduced physical disability, and right anterior insula was associated specifically with reduced pain. Left DLPFC activity during an attention-demanding cognitive task was abnormal before treatment, but normalized following treatment. These data indicate that functional and structural brain abnormalities-specifically in the left DLPFC-are reversible, suggesting that treating chronic pain can restore normal brain function in humans.

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Section: Future Directionssupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function

et al. 2011

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“…More anxious females might display lower pain thresholds, resulting in enhanced HPA-system reactivity (Stones et al, 1999). However, it has been shown that HF-rTMS applied to the left DLPFC results in reduced pain perceptions in healthy subjects (Borckardt et al, 2007;Fierro et al, 2010). In addition, the possibility that 'more anxious' healthy subjects are more susceptible to pain sensations, resulting in a more sensitive HPA system reactivity due to the real HFrTMS application, remains an open question as contrasting findings on the relationship between anxiety, stress and pain perception have been reported (Bement et al, in press).…”

Section: Discussionmentioning

confidence: 99%

Baseline ‘state anxiety’ influences HPA-axis sensitivity to one sham-controlled HF-rTMS session applied to the right dorsolateral prefrontal cortex

Baeken¹,

Vanderhasselt²,

Raedt³

2011

Psychoneuroendocrinology

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2 SummaryAlthough negative results have been reported, an important aspect of the physiology of repetitive Transcranial Magnetic Stimulation (rTMS) could be related to the endocrinological response of the hypothalamic-pituitaryadrenal (HPA) axis, such as cortisol secretion. Because endocrinological responses are influenced by anxiety states, this could influence the effect of rTMS in healthy individuals. In this sham-controlled, "single blind" crossover study, we examined whether one session of HF-rTMS could affect the HPA-system, when taking into account individual state anxiety scores based on the State-Trait Anxiety Inventory (STAI). Twenty-four healthy rTMS naïve females received one sham-controlled high frequency (HF)-rTMS session delivered on the right dorsolateral prefrontal cortex (DLPFC). The Profile of Mood States (POMS) questionnaire, together with salivary cortisol samples, was collected before, just after and 30 minutes post HF-rTMS. To examine whether state anxiety could influence endocrinological outcome measurements, we administered the STAI-state just before each HF-rTMS experiment started. Based on the POMS questionnaire, no mood changes were observed.Without taking individual state anxiety scores into account, one sham-controlled right-sided HF-rTMS session did not influence the HPA-system. When taking into account individual STAI-state scores, we found that healthy women scoring higher on the STAI-state displayed a significantly more sensitive HPA-system, resulting in salivary cortisol concentration increases after real HF-rTMS, compared to those scoring lower on this anxiety scale. Our results indicate that healthy women scoring high on state anxiety display a more sensitive HPAsystem when receiving one right-sided HF-rTMS session. Our findings suggest that the incorporation of individual anxiety states in experimental rTMS research could add further information about its neurobiological influences on the HPA-system.

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“…Furthermore, the reduced rsFC from both MHb and LHb to the aMCC and pACC may link chronic pain states to changes in negative affect, pain, and cognitive control (Vogt 2005;Geha et al 2008;Shackman et al 2011). Another interesting finding relates to the reduced rsFC to the pgACC previously implicated in pain inhibition systems (Petrovic et al 2002;Wager et al 2004;Bingel et al 2006) and to the dlPFC repeatedly associated with pain modulation (Lorenz et al 2003;Brighina et al 2004;Fierro et al 2010), perceived control over pain (Pariente et al 2005;Wiech et al 2006), and pain catastrophizing (Seminowicz and Davis 2006).…”

Section: Hb Rsfc Group Differencesmentioning

confidence: 99%

Habenula functional resting-state connectivity in pediatric CRPS

Erpelding

Sava

Simons

et al. 2014

Journal of Neurophysiology

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The habenula (Hb) is a small brain structure located in the posterior end of the medial dorsal thalamus and through medial (MHb) and lateral (LHb) Hb connections, it acts as a conduit of information between forebrain and brainstem structures. The role of the Hb in pain processing is well documented in animals and recently also in acute experimental pain in humans. However, its function remains unknown in chronic pain disorders. Here, we investigated Hb resting-state functional connectivity (rsFC) in patients with complex regional pain syndrome (CRPS) compared with healthy controls. Twelve pediatric patients with unilateral lower-extremity CRPS (9 females; 10–17 yr) and 12 age- and sex-matched healthy controls provided informed consent to participate in the study. In healthy controls, Hb functional connections largely overlapped with previously described anatomical connections in cortical, subcortical, and brainstem structures. Compared with controls, patients exhibited an overall Hb rsFC reduction with the rest of the brain and, specifically, with the anterior midcingulate cortex, dorsolateral prefrontal cortex, supplementary motor cortex, primary motor cortex, and premotor cortex. Our results suggest that Hb rsFC parallels anatomical Hb connections in the healthy state and that overall Hb rsFC is reduced in patients, particularly connections with forebrain areas. Patients' decreased Hb rsFC to brain regions implicated in motor, affective, cognitive, and pain inhibitory/modulatory processes may contribute to their symptomatology.

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Repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) during capsaicin-induced pain: modulatory effects on motor cortex excitability

Cited by 121 publications

References 41 publications

Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function

Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function

Baseline ‘state anxiety’ influences HPA-axis sensitivity to one sham-controlled HF-rTMS session applied to the right dorsolateral prefrontal cortex

Habenula functional resting-state connectivity in pediatric CRPS

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