The precentral gyrus (M1) is a representative target for electrical stimulation therapy of pain. To date, few researchers have investigated whether pain relief is possible by stimulation of cortical areas other than M1. According to recent reports, repetitive transcranial magnetic stimulation (rTMS) can provide an effect similar to that of electrical stimulation. With this in mind, we therefore examined several cortical areas as stimulation targets using a navigation-guided rTMS and compared the effects of the different targets on pain. Twenty patients with intractable deafferentation pain received rTMS of M1, the postcentral gyrus (S1), premotor area (preM), and supplementary motor area (SMA). Each target was stimulated with ten trains of 10-s 5-Hz TMS pulses, with 50-s intervals in between trains. Intensities were adjusted to 90% of resting motor thresholds. Thus, a total of 500 stimuli were applied. Sham stimulations were undertaken at random. The effect of rTMS on pain was rated by patients using a visual analogue scale (VAS) and the short form of the McGill Pain Questionnaire (SF-MPQ). Ten of the 20 patients (50%) indicated that stimulation of M1, but not other areas, provided significant and beneficial pain relief (p<0.01). Results indicated a statistically significant effect lasting for 3 hours after the stimulation of M1 (p<0.05). Stimulation of other targets was not effective. The M1 was the sole target for treating intractable pain with rTMS, in spite of the fact that M1, S1, preM, and SMA are located adjacently.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.pain.2005.12.001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Human dorsal root ganglia are either preserved or completely lost after deafferentation by brachial plexus injury.
Br J Anaesth
December 2024
Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Centre for Interdisciplinary Pain Medicine, University Hospital of Würzburg, Würzburg, Germany. Electronic address:
Article Synopsis
- Plexus injuries lead to chronic issues like paralysis, sensory loss, and pain, prompting interest in how the dorsal root ganglia (DRG) are affected following such injuries.
- A study involving 13 patients revealed that in about half, the typical cell structure of DRG was lost replaced by connective tissue, while others maintained their cellular integrity, although those with preserved neurons reported less pain.
- The findings suggest two distinct patient groups: those with neuronal preservation who might benefit from anti-inflammatory treatments, and those with neuronal loss needing further research for potential regenerative therapies.
Open and Percutaneous Trigeminal Nucleotractotomy: A Case Series and Literature Review.
Stereotact Funct Neurosurg
December 2023
Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
Introduction: Nucleotractotomy is an efficient surgical technique that provides a high pain relief rate for specific clinical indications. There are two main approaches for performing this operation: an open and percutaneous technique.
Methods: In the Federal Center of Neurosurgery (Novosibirsk, Russia) from 2016 to 2022, 13 trigeminal nucleotractotomies (7 open and 6 percutaneous) were performed in 12 patients (5 women and 7 men).
Stroke-Induced Central Pain: Overview of the Mechanisms, Management, and Emerging Targets of Central Post-Stroke Pain.
Pharmaceuticals (Basel)
August 2023
Department of Clinical Pharmacy, College of Pharmacy, Jazan University, P.O. Box 114, Jazan 45142, Saudi Arabia.
The incidence of stroke plays the foremost role in the genesis of central neuropathic pain. Central post-stroke pain (CPSP) is a central pain arising from a vascular lesion in the central nervous system that elicits somatosensory deficits, often contralateral to stroke lesions. It is expressed as continuous or intermittent pain accompanied by sensory abnormalities like dysesthesia and allodynia.
View Article and Find Full Text PDFCurrent Understanding of Phantom Pain and its Treatment.
Pain Physician
October 2022
Department of Pain Medicine, Division of Anesthesiology, Critical Care, Medicine, and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
Background: Phantom limb pain (PLP), defined as a painful sensation in a portion of the body that has been amputated, occurs in upwards of 80% of limb amputees and can significantly impact a patient's quality of life. First hypothesized in 1551, the disease has been poorly understood for much of this time. Still today, the exact etiology of the condition is yet to be elucidated.
View Article and Find Full Text PDFFunctional MRI-Guided Motor Cortex and Deep Brain Stimulation for Intractable Facial Pain: A Novel, Personalized Approach in 1 Patient.
Oper Neurosurg (Hagerstown)
January 2023
Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Background: Facial neuropathic pain syndromes such as trigeminal neuralgia are debilitating disorders commonly managed by medications, vascular decompression, and/or ablative procedures. In trigeminal neuralgia cases unresponsive to these interventions, trigeminal deafferentation pain syndrome (TDPS) can emerge and remain refractory to any further attempts at these conventional therapies. Deep brain stimulation (DBS) and motor cortex stimulation are 2 neuromodulatory treatments that have demonstrated efficacy in small case series of TDPS yet remain largely underutilized.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!