rTMS for Suppressing Neuropathic Pain: A Meta-Analysis

Leung, Albert; Donohue, Michael C.; Xu, Ronghui; Lee, Ryan; Lefaucheur, Jean‐Pascal; Khedr, Eman M.; Saitoh, Youichi; Obadia, Nathalie; Rollnik, Jens D.; Wallace, Mark; Chen, Robert

doi:10.1016/j.jpain.2009.03.010

Cited by 185 publications

(121 citation statements)

References 85 publications

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“…Further, high frequency rTMS of M1 in healthy populations show this technique can modulate experimental pain thresholds [16,26]. It is thought rTMS acts to modulate pathways from the insula and orbitofrontal cortex to the posterior thalamus in order to upregulate these pain thresholds [12]. The effects of high frequency rTMS on pain thresholds have been demonstrated to last up to eight days [11].…”

Section: Rtmsmentioning

confidence: 99%

Transcranial direct current stimulation (tDCS) priming of 1Hz repetitive transcranial magnetic stimulation (rTMS) modulates experimental pain thresholds

Moloney

Witney

2013

Neuroscience Letters

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Section: Rtmsmentioning

confidence: 99%

Transcranial direct current stimulation (tDCS) priming of 1Hz repetitive transcranial magnetic stimulation (rTMS) modulates experimental pain thresholds

Moloney

Witney

2013

Neuroscience Letters

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“…70 Over the past decade, several studies have shown that rTMS applied over the motor cortex can also, at least temporarily, alleviate neuropathic pain. [71][72][73][74] To date, about 20 studies have assessed the efficacy of rTMS in more than 300 persons with drugresistant chronic neuropathic pain of diverse origins (including post-stroke pain, CRPS, trigeminal neuralgia, amputation, spinal-cord injury, and brachial plexus avulsion), 74 and recent meta-analyses showed that highfrequency rTMS is associated with significant pain relief. 72,73 Does the reduction in pain following stimulation of the motor cortex indicate that motor-cortex plasticity is a cause of chronic neuropathic pain?…”

Section: Can the Induction Of Motor Plasticity By Means Of Motor-cortmentioning

confidence: 99%

Interactions between Pain and the Motor Cortex: Insights from Research on Phantom Limb Pain and Complex Regional Pain Syndrome

Mercier

Léonard²

2011

Physiotherapy Canada

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Purpose: Pain is a significantly disabling problem that often interacts with other deficits during the rehabilitation process. The aim of this paper is to review evidence of interactions between pain and the motor cortex in order to attempt to answer the following questions: (1) Does acute pain interfere with motorcortex activity? (2) Does chronic pain interfere with motor-cortex activity, and, conversely, does motor-cortex plasticity contribute to chronic pain? (3) Can the induction of motor plasticity by means of motor-cortex stimulation decrease pain? (4) Can motor training result in both motor-cortex reorganization and pain relief? Summary of Key Points: Acute experimental pain has been clearly shown to exert an inhibitory influence over the motor cortex, which can interfere with motor learning capacities. Current evidence also suggests a relationship between chronic pain and motor-cortex reorganization, but it is still unclear whether one causes the other. However, there is growing evidence that interventions aimed at normalizing motor-cortex organization can lead to pain relief. Conclusions: Interactions between pain and the motor cortex are complex, and more studies are needed to understand these interactions in our patients, as well as to develop optimal rehabilitative strategies.Key Words: motor control, motor cortex, pain, plasticity, rehabilitation RÉ SUMÉObjectif : La douleur est considé rablement invalidante et pré sente souvent des interactions avec d'autres dé ficits au cours du processus de ré adaptation. L'objectif de cet article est d'analyser donné e supportant la pré sence d'interactions entre la douleur et le cortex moteur afin de tenter de ré pondre aux questions suivantes : (1) La douleur aiguë nuit-elle à l'activité du cortex moteur? (2) La douleur chronique altè re-t-elle l'activité du cortex moteur et, ré ciproquement, la ré organisation du cortex moteur contribue-t-elle à la douleur chronique? (3) L'induction de la plasticité motrice par stimulation du cortex moteur peut-elle ré duire la douleur? (4) L'entraînement moteur peut-il amener à la fois une ré organisation du cortex moteur et un soulagement de la douleur? Ré sumé des principaux points : Il a é té clairement dé montré que la douleur aiguë expé rimentale exerce une influence inhibitoire sur le cortex moteur, qui peut entraver les capacité s d'apprentissage moteur. Les donné e actuelles suggè rent é galement qu'il existe une relation entre la douleur chronique et la ré organisation du cortex moteur, mais il n'est pas clair que l'un provoque l'autre. Il existe toutefois des preuves de plus en plus nombreuses que les interventions visant à normaliser l'organisation du cortex peuvent amener un soulagement de la douleur. Conclusions : Les interactions entre la douleur et le cortex moteur sont complexes et d'autres é tudes sont né cessaires pour comprendre ces interactions chez nos patients et pour concevoir des straté gies de ré adaptation optimales.

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“…Furthermore, a recent meta-analysis studied the effects of TMS on neuropathic pain, including post-stroke supra-spinal related pain, and concluded that TMS provides a significant reduction invarious neuropathic pain conditions [21][22][23][24][25]. There are three main proposed mechanisms for this: 1) induction of neuroplasticity can allow for the brain to simply reorganize itself in a way that reverses the plasticity induced with neuropathic pain, 2) direct stimulation of descending inhibitory pathways to decrease the response to painful stimuli, 3) direct stimulation of endogenous opioid secretions [19].…”

Section: Transcranial Magnetic Stimulation/transcranial Direct Currenmentioning

confidence: 99%

The Promising Role of Neuromodulation in Improving Ischemic Stroke Recovery

LoPresti¹,

Camacho²,

Appelboom³

et al. 2015

J Neurol Neurosurg

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Strokes continue to be a leading cause of death and carries significant morbidity impacting the quality of life for survivors. Although there are preventative measures and growing hyperacute treatments, physical and occupational rehabilitation continue to be the main modalities for recovery of motor abilities, cognitive function, and resolution of pain syndromes post-stroke. Neuromodulation therapies hold great promise for stroke survivors and are beginning to gain traction as the next frontier in regards to post-stroke rehabilitation. It is the aim of this review to explore current beliefs regarding post-acute stroke recovery through neuroplasticity of surviving brain tissue and the impact of neuromodulation through non-invasive and invasive interventions. By understanding the scope of these interventions, the areas in which neuromodulation may be most effective, and the types of recovery they may help constitute, the impact of neuromodulation as a budding area in neurological care and therapy can be better characterized and outlined for future study.

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rTMS for Suppressing Neuropathic Pain: A Meta-Analysis

Cited by 185 publications

References 85 publications

Transcranial direct current stimulation (tDCS) priming of 1Hz repetitive transcranial magnetic stimulation (rTMS) modulates experimental pain thresholds

Transcranial direct current stimulation (tDCS) priming of 1Hz repetitive transcranial magnetic stimulation (rTMS) modulates experimental pain thresholds

Interactions between Pain and the Motor Cortex: Insights from Research on Phantom Limb Pain and Complex Regional Pain Syndrome

The Promising Role of Neuromodulation in Improving Ischemic Stroke Recovery

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