Somatotopic effects of <scp>rTMS</scp> in neuropathic pain? A comparison between stimulation over hand and face motor areas

André‐Obadia, Nathalie; Magnin, M.; Simon, É.; Garcia-Larrea, Luis

doi:10.1002/ejp.1156

Cited by 49 publications

(46 citation statements)

References 48 publications

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“…From those, 29 were selected for full-length text retrieval and 14 met the selection criteria. 28 – 41 Hand search of the references from the eligible studies revealed two more studies that were also included in the full-length text retrieval phase but that did not meet the inclusion criteria. Figure 1 depicts a more detailed description of this process using a PRISMA flow diagram.…”

Section: Resultsmentioning

confidence: 99%

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Non-invasive brain stimulation in chronic orofacial pain: a systematic review

Babiloni¹,

Guay²,

Nixdorf³

et al. 2018

JPR

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BackgroundTranscranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation techniques that are being explored as therapeutic alternatives for the management of various chronic pain conditions.ObjectiveThe primary objective of this systematic review is to assess the efficacy of TMS and tDCS in reducing clinical pain intensity in chronic orofacial pain (OFP) disorders. The secondary objectives are to describe adverse effects, duration of relief, and TMS/tDCS methodologies used in chronic OFP disorders.MethodsA search was performed in MEDLINE, Embase, Web of Science, Scopus, and Google Scholar. Inclusion criteria were 1) population: adults diagnosed with chronic OFP including neuropathic and non-neuropathic disorders; 2) intervention: active TMS or tDCS stimulation regardless of the used protocol; 3) comparison: sham TMS or tDCS stimulation; and 4) outcome: primary outcome was patient reported pain intensity. Secondary outcomes were duration of pain relief, adverse effects, and methodological parameters. Risk of bias and quality of study reporting were also assessed.ResultsA total of 556 individual citations were identified by the search strategy, with 14 articles meeting selection criteria (TMS=11; tDCS=3). Data were obtained for a total of 228 patients. Included OFP disorders were trigeminal neuralgia, trigeminal neuropathy, burning mouth syndrome, atypical facial pain, and temporomandibular disorders. Significant pain reductions were obtained in both techniques. More number of sessions yielded to more durable effects. Overall, high risk of bias and poor study quality were found.ConclusionTMS and tDCS appear to be safe and promising alternatives to reduce pain intensity in different chronic OFP disorders. Additional research effort is needed to reduce bias, improve quality, and characterize optimal brain stimulation parameters to promote their efficacy.

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Section: Resultsmentioning

confidence: 99%

“…Importantly, ten references were not included as individualized OFP data could not be extracted from the accessible results, which included chronic pain disorders that can be present in the face. Thus, 11 TMS 28 – 38 and 3 tDCS 39 – 41 studies were included in this systematic review providing data on a total of 228 patients.…”

Section: Resultsmentioning

confidence: 99%

Non-invasive brain stimulation in chronic orofacial pain: a systematic review

Babiloni¹,

Guay²,

Nixdorf³

et al. 2018

JPR

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“…Our literature search located 19 studies that examined the clinical usefulness of rTMS to control chronic NP (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(27)(28)(29)(30)(31)(32)(33). Among the 19 studies, two were randomized controlled trials (RCTs) (19,23).…”

Section: Neuropathic Pain Of Various Originsmentioning

confidence: 99%

“…In 2016, three more studies (27)(28)(29) supported that rTMS stimulation over the M1 effectively relieved NP. Furthermore, studies conducted in 2017 and 2018 reported that high-frequency (5-20 Hz) stimulations effectively controlled NP (30,31,33). In contrast to these positive results, two prospective observational studies (13,15) and one case study (32) reported that there were no differences between rTMS and sham stimulations on NP relief.…”

Section: Neuropathic Pain Of Various Originsmentioning

confidence: 99%

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

Yang

Lee

2020

Front. Neurol.

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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.

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“…Die Spule sollte entweder über dem motorischen Hotspot der Hand oder einer Muskelgruppe in der Schmerzregion oder mit einem MRT-/fMRT-basierten Navigationssystem über M1 der Hand oder der motorkortikalen Repräsentation der Schmerzregion positioniert werden. Eine Studie [47] zeigte, dass bei Gesichtsschmerzen rTMS über dem Hotspot der Hand wirksamer ist als über dem Hotspot des Gesichtes. Demnach könnte der Hotspot für die Hand die beste Spulenposition sein, ungeachtet der Lokalisation des Schmerzes.…”

Section: Andere Kortikale Stimulationsorteunclassified

Transkranielle Magnetstimulation

Golaszewski¹,

Nardone²

2020

Nervenheilkunde

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ZUSAMMENFASSUNGDie repetitive transkranielle Magnetstimulation ermöglicht eine nicht invasive Modulation der kortikalen Erregbarkeit des Gehirns, welche durch verschiedene Stimulationsparameter erhöht oder verringert werden kann. Die induzierten Veränderungen können vorübergehend oder längerfristig sein. Es können im Gehirn unterschiedliche neuromodulatorische Prozesse hinsichtlich der stimulierten Region und des stimulierten neuronalen Gewebes induziert werden, was die Schmerzwahrnehmung im Gehirn verändern kann. Es werden kontinuierliche Serien von TMS-Pulsen mit niedriger (≤ 1Hz) oder höherer Frequenz (> 1Hz) mit Hemmung oder Fazilitierung der kortikalen Erregbarkeit durch Veränderungen der synaptischen Transmission angewendet, was zu synaptischer Plastizität insbesondere im Bereich der Langzeitpotenzierung (LTP) oder Langzeitdepression (LTD) führt. Hinreichend Evidenz für die Wirksamkeit der rTMS in der Schmerztherapie gibt es insbesondere für chronisch neuropathische Schmerzen zentraler oder peripherer Genese und für die Fibromyalgie.

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Somatotopic effects of rTMS in neuropathic pain? A comparison between stimulation over hand and face motor areas

Abstract: Strict somatotopic targeting of rTMS does not appear warranted for the treatment of upper limb or face NP. Since the hand motor area is easier to target and provides better results, it might be privileged for both types of pain.

Cited by 49 publications

References 48 publications

Non-invasive brain stimulation in chronic orofacial pain: a systematic review

Non-invasive brain stimulation in chronic orofacial pain: a systematic review

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

Transkranielle Magnetstimulation

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