<scp>H</scp>‐coil repetitive transcranial magnetic stimulation for pain relief in patients with diabetic neuropathy

Onesti, Emanuela; Gabriele, M.; Cambieri, Chiara; Ceccanti, Marco; Raccah, Ruggero; Stefano, Giulia Di; Biasiotta, A.; Truini, Andrea; Zangen, Abraham; Inghilleri, Maurizio

doi:10.1002/j.1532-2149.2013.00320.x

Cited by 93 publications

(82 citation statements)

References 55 publications

(69 reference statements)

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“…Recently, indirect evidence has emerged that an additional mechanism, modulation of the descending pathways, can also play a role, as demonstrated for epidural motor cortex stimulation induced analgesia [40]. Onesti et al [41] showed that during TMS of M1 for pain relief in diabetic neuropathy the nociceptive R III reflex was reduced, and this is thought to represent an inhibitory action from descending neuromodulatory pathways. We found that M1 stimulation had a significantly greater analgesic effect than that of DLFPC, however the close association between prefrontal and motor areas is well recognized.…”

Section: Discussionmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation over primary motor vs non-motor cortical targets; effects on experimental hyperalgesia in healthy subjects

et al. 2014

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BackgroundHigh frequency repetitive transcranial magnetic stimulation (rTMS) targetted to different cortical regions (primary motor/sensory, prefrontal) are known to alter somatosensory responses. The mechanism(s) for these effects are unclear. We compared the analgesic effects of rTMS at different cortical sites on hyperalgesia induced using topical capsaicin cream.MethodsFourteen healthy subjects had capsaicin cream applied to a 16 cm2 area of the medial aspect of the right wrist (60 min) on 4 separate occasions over 6 weeks. rTMS (10Hz for 10s/min = 2000 stimuli @ 90% resting motor threshold of first dorsal interosseus muscle) was applied to the optimum site for right hand (M1), left dorsolateral prefrontal (DLFPC) and occipital midline (OCC) in a pseudo-randomised order. Thermal and mechanical perception and pain thresholds were determined using standardised quantitative sensory testing (QST) methods at the capsaicin site. Subjective responses to thermal stimuli (pain score on a numerical rating scale) from −2.5°C to +2.5°C of the individualised heat pain threshold (HPT) resulted in a hyperalgesia curve. Sensory testing took place prior to capsaicin application (PRE-CAP), after 30 min of capsaicin (POST-CAP) and following rTMS (30 min = POST-TMS).ResultsCapsaicin application resulted in substantial changes in thermal (but not mechanical) sensitivity to both heat and cold (eg. HPT PRE-CAP = 43.6°C to POST-CAP = 36.7°C (p < 0.001)) with no differences between groups pre-rTMS. POST-TMS HPT showed no changes for any of the treatment groups, however the pain scores for the hyperalgesia curve were significantly lower for M1 vs OCC (−24.7%, p < 0.001) and for M1 vs DLFPC (−18.3%, p < 0.02).ConclusionrTMS over the primary motor cortex results in a significant analgesic effect compared to other cortical areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-014-0166-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Repetitive transcranial magnetic stimulation over primary motor vs non-motor cortical targets; effects on experimental hyperalgesia in healthy subjects

et al. 2014

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“…[76][77][78] Moreover, using a H-coil designed to target the lower-limb motor cortex, analgesic effects have been obtained in patients with painful diabetic neuropathy. 79 …”

Section: Repetitive Tms (Rtms) and Theta Burst Stimulation (Tbs)mentioning

confidence: 99%

Noninvasive Neuromodulation in Poststroke Gait Disorders

Chieffo

Comı

Leocani

2015

Neurorehabil Neural Repair

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Walking rehabilitation is one of the primary goals in stroke survivors because of its great potential for recovery and its functional relevance in daily living activities. Although 70% to 80% of people in the chronic poststroke phases are able to walk, impairment of gait often persists, involving speed, endurance, and stability. Walking involves several brain regions, such as the sensorimotor cortex, supplementary motor area, cerebellum, and brainstem, which are approachable by the application of noninvasive brain stimulation (NIBS). NIBS techniques, such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation, have been reported to modulate neural activity beyond the period of stimulation, facilitating neuroplasticity. NIBS methods have been largely applied for improving paretic hand motor function and strokeassociated cognitive deficits. Recent studies suggest a possible effectiveness of these techniques also in the recovery of poststroke gait disturbance. This article is a selective review about functional investigations addressing the mechanisms of lower-limb motor system reorganization after stroke and the application of NIBS for neurorehabilitation.

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“…dTMS has opened a perspective to test new targets in a non-invasively way such as the insula and other areas involved in many aspects of pain sensation as emotion, behavior and pain control. A further interesting aspect is that rTMS apparently can foresee the effect of epidural MCS; consequently its use would improve the selection of patients to this invasive procedure [66]. Regarding invasive techniques, it is hard to believe that a randomized multicentric controlled doubleblinded study could be performed due to ethical and operational issues, but it seems to be an efficient approach based on prospective case-series reported.…”

Section: Future Prospectsmentioning

confidence: 99%

Neuromodulation in Treating Complex Regional Pain Syndrome: A Critical Review of the Evidence

Picarelli¹,

Sterman-Neto²,

De-Oliveira³

et al. 2017

J Neurol Neurosci

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Background and objectives: The management of complex regional pain syndrome (CRPS) remains a challenging task therefore a large number of interventions have been investigated.Lately, invasive and non-invasive neuromodulation have been coming up as an alternative for some patients even as an add-on treatment to medicines or physical therapy. The objective of this review is to evaluate the evidence of its effectiveness in CRPS chronic pain management.

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H‐coil repetitive transcranial magnetic stimulation for pain relief in patients with diabetic neuropathy

Cited by 93 publications

References 55 publications

Repetitive transcranial magnetic stimulation over primary motor vs non-motor cortical targets; effects on experimental hyperalgesia in healthy subjects

Repetitive transcranial magnetic stimulation over primary motor vs non-motor cortical targets; effects on experimental hyperalgesia in healthy subjects

Noninvasive Neuromodulation in Poststroke Gait Disorders

Neuromodulation in Treating Complex Regional Pain Syndrome: A Critical Review of the Evidence

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