OBJECTIVE: To study the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) of the motor cortex on central pain in patients with chronic spinal cord injury (SCI). DESIGN: Double-blind randomized controlled trial. Mean follow-up period was 4.5 weeks. SETTING: General hospital. PARTICIPANTS: Twelve paraplegic patients due to thoracic SCI suffering chronic central pain (11 completed the study) who were randomly selected from a list of eligible patients. INTERVENTION: Real or sham 10 daily motor rTMS treatments (500 trains at 5 Hz for 10 s; total of 500 pulses at intensity of 115% of motor threshold) using figure-of-8 coil over the vertex. MAIN OUTCOME MEASURES: Chronic pain intensity (visual analog scale [VAS], McGill PainQuestionnaire [MPQ]), pain threshold, and level of depression (Beck Depression Inventory). RESULTS: Both real and sham TMS induced a similar, significant reduction in VAS scores (P<.001) immediately after each of the 10 treatment sessions and in VAS and MPQ scores after the end of the treatment series. However, only real rTMS conferred a significant increase in heat-pain threshold (4 degrees C, P<.05) by the end of the series. Most important, the reduction in MPQ scores in the real rTMS group continued during the follow-up period. Depression scores were equally reduced in both groups but similar to pain relief, depression continued to improve at follow-up in the real rTMS group. CONCLUSIONS: Whereas the pain alleviation induced by a single rTMS treatment is probably due to placebo, patients with SCI may benefit from a series of rTMS treatments.
RCT Entities:
OBJECTIVE: To study the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) of the motor cortex on central pain in patients with chronic spinal cord injury (SCI). DESIGN: Double-blind randomized controlled trial. Mean follow-up period was 4.5 weeks. SETTING: General hospital. PARTICIPANTS: Twelve paraplegic patients due to thoracic SCI suffering chronic central pain (11 completed the study) who were randomly selected from a list of eligible patients. INTERVENTION: Real or sham 10 daily motor rTMS treatments (500 trains at 5 Hz for 10 s; total of 500 pulses at intensity of 115% of motor threshold) using figure-of-8 coil over the vertex. MAIN OUTCOME MEASURES: Chronic pain intensity (visual analog scale [VAS], McGill Pain Questionnaire [MPQ]), pain threshold, and level of depression (Beck Depression Inventory). RESULTS: Both real and sham TMS induced a similar, significant reduction in VAS scores (P<.001) immediately after each of the 10 treatment sessions and in VAS and MPQ scores after the end of the treatment series. However, only real rTMS conferred a significant increase in heat-pain threshold (4 degrees C, P<.05) by the end of the series. Most important, the reduction in MPQ scores in the real rTMS group continued during the follow-up period. Depression scores were equally reduced in both groups but similar to pain relief, depression continued to improve at follow-up in the real rTMS group. CONCLUSIONS: Whereas the pain alleviation induced by a single rTMS treatment is probably due to placebo, patients with SCI may benefit from a series of rTMS treatments.
Authors: Muhammad Abul Hasan; Aleksandra Vuckovic; Saad A Qazi; Zuha Yousuf; Sania Shahab; Matthew Fraser Journal: Neurol Sci Date: 2021-02-23 Impact factor: 3.307
Authors: R Nardone; Y Höller; P B Langthaler; P Lochner; S Golaszewski; K Schwenker; F Brigo; E Trinka Journal: Spinal Cord Date: 2016-05-31 Impact factor: 2.772
Authors: Raffaele Nardone; Yvonne Höller; Stefan Leis; Peter Höller; Natasha Thon; Aljoscha Thomschewski; Stefan Golaszewski; Francesco Brigo; Eugen Trinka Journal: J Spinal Cord Med Date: 2013-11-26 Impact factor: 1.985
Authors: Swati Mehta; Katherine Orenczuk; Amanda McIntyre; Gabrielle Willems; Dalton L Wolfe; Jane T C Hsieh; Christine Short; Eldon Loh; Robert W Teasell Journal: Top Spinal Cord Inj Rehabil Date: 2013