rTMS of the prefrontal cortex has analgesic effects on neuropathic pain in subjects with spinal cord injury

Nardone, Raffaele; Höller, Yvonne; Langthaler, Patrick B.; Lochner, Piergiorgio; Golaszewski, Stefan; Schwenker, Kerstin; Brigo, Francesco; Trinka, Eugen

doi:10.1038/sc.2016.87

Cited by 65 publications

(84 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…ACC is linked to the affective processing of pain, and also likely serves as an important relay station in descending inhibitory control of pain (Bingel et al, 2006; Lieberman and Eisenberger, 2015; Qu et al, 2011; Rainville et al, 1997; Rance et al, 2014; Russo and Sheth, 2015). PF has been proposed as a modulatory area for pain (Hardy and Haigler, 1985; Jahn et al, 2016; Lorenz et al, 2003; Nardone et al, 2017; Wiech et al, 2006). Nevertheless, detection of nociceptive heat-evoked fMRI signal changes in these two cortices (ACC and PF), as well as their robust functional connections to the pIns region under anesthesia, further supports their fundamental roles in nociceptive information processing without consciousness.…”

Section: Discussionmentioning

confidence: 99%

High-resolution functional MRI identified distinct global intrinsic functional networks of nociceptive posterior insula and S2 regions in squirrel monkey brain

Wang

Yang

et al. 2017

NeuroImage

View full text Add to dashboard Cite

Numerous functional imaging and electrophysiological studies in humans and animals indicate that the two contiguous areas of secondary somatosensory cortex (S2) and posterior insula (pIns) are core regions in nociceptive processing and pain perception. In this study, we tested the hypothesis that the S2-pIns connection serves as a hub for connecting distinct sensory and affective nociceptive processing networks in the squirrel monkey brain. At 9.4T, we first mapped the brain regions that respond to nociceptive heat stimuli with high-resolution fMRI, and then used seed-based resting-state fMRI (rsfMRI) analysis to delineate and refine the global intrinsic functional connectivity circuits of the proximal S2 and pIns regions. In each subject, nociceptive (47.5 °C) heat-evoked fMRI activations were detected in many brain regions, including primary somatosensory (S1), S2, pIns, area 7b, anterior cingulate cortex (ACC), primary motor cortex (M1), prefrontal cortex (PF), supplementary motor area (SMA), thalamus, and caudate. Using the heat-evoked fMRI activation foci in S2 and pIns as the seeds, voxel-wise whole-brain resting-state functional connectivity (rsFC) analysis revealed strong functional connections between contralateral S2 and pIns, as well as their corresponding regions in the ipsilateral hemisphere. Spatial similarity and overlap analysis identified each region as part of two distinct intrinsic functional networks with 7% overlap: sensory S2-S1-area 7b and affective pIns-ACC-PCC networks. Moreover, a high degree of overlap was observed between the combined rsFC maps of nociceptive S2 and pIns regions and the nociceptive heat-evoked activation map. In summary, our study provides evidence for the existence of two distinct intrinsic functional networks for S2 and pIns nociceptive regions, and these two networks are joined via the S2-pIns connection. Brain regions that are involved in processing nociceptive inputs are also highly interconnected at rest. The presence of robust and distinct S1-S2-area 7b and pIns-ACC-PCC rsFC networks under anesthesia underscores their fundamental roles in processing nociceptive information.

show abstract

Section: Discussionmentioning

confidence: 99%

High-resolution functional MRI identified distinct global intrinsic functional networks of nociceptive posterior insula and S2 regions in squirrel monkey brain

Wang

Yang

et al. 2017

NeuroImage

View full text Add to dashboard Cite

show abstract

“…Three RCTs (44,47,48) and two prospective observational studies (45,46) revealed that rTMS effectively managed chronic central pain in patients with SCI. Among the RCTs, Nardone et al (48) performed 10 sessions of 10-Hz rTMS stimulation over the left prefrontal cortex in 12 patients with complete or incomplete motor SCI. The VAS scores of six patients in the real rTMS group decreased over time, and the differences in VAS scores between patients in the real rTMS group and the six patients in the sham group showed that rTMS effectively relieved pain in patients with SCI after 2 weeks of treatment.…”

Section: Central Pain After Scimentioning

confidence: 99%

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

Yang

Lee

2020

Front. Neurol.

View full text Add to dashboard Cite

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.

show abstract

“…In addition, the responsiveness of varies types of neuropathic pain was not further differentiated [24][25][26][27]. Stimulation of DLPFC is based on the concept that, besides chronic pain, a positive effect is exerted on the depression component (e.g., [15,28]).…”

Section: Application Of Rtms and Tdcs In Pain Patientsmentioning

confidence: 99%

New Results on Brain Stimulation in Chronic Pain

Antal¹,

Paulus²,

Rohde

2017

Neurology International Open

View full text Add to dashboard Cite

Chronic pain induces a change of the anatomical pain network, primarily comprising DLPFC, M1, somatosensory cortex, the anterior cingulate cortex, and the thalamus. In patients with chronic back pain, a progressive decrease in neocortical gray matter (DLPFC) of 5-11 % compared to healthy subjects is observed over the years [8]. Per pain year the loss of gray matter density was approximately 1.3 cm 3 .

show abstract

rTMS of the prefrontal cortex has analgesic effects on neuropathic pain in subjects with spinal cord injury

Abstract: The findings of this preliminary study in a small patient sample suggest that rTMS of the PMC/DLPFC may be effective in relieving neuropathic pain in SCI patients.

Cited by 65 publications

References 54 publications

High-resolution functional MRI identified distinct global intrinsic functional networks of nociceptive posterior insula and S2 regions in squirrel monkey brain

High-resolution functional MRI identified distinct global intrinsic functional networks of nociceptive posterior insula and S2 regions in squirrel monkey brain

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

New Results on Brain Stimulation in Chronic Pain

Contact Info

Product

Resources

About