Neural Correlates of the Antinociceptive Effects of Repetitive Transcranial Magnetic Stimulation on Central Pain After Stroke

Neurorehabilitation and Neural Repair, 05/25/2012

Mood may affect the modest antinociceptive effects of Repetitive transcranial magnetic stimulation (rTMS) that the authors found, which may be mediated by the superior thalamocortical tract (TCT) through modulation of a distributed pain network.

Methods

  • Each patient underwent daily 10-Hz rTMS sessions for 1000 pulses on 5 consecutive days over the hotspot for the first dorsal interosseus muscle.
  • Pain severity was monitored using the Visual Analogue Scale (VAS).
  • Mood was assessed by the Hamilton Depression Rating Scale.

Results

  • Clinical data from all participants along with the DTI and fMRI findings from 10 patients were analyzed.
  • VAS scores decreased significantly, if modestly, following administration of rTMS in 14 responders, which lasted for 2 weeks after the intervention.
  • Regression analysis showed a significant correlation between less initial depression and higher antalgic effect of rTMS.
  • Integrity of the superior TCT in the ipsilesional hemisphere showed significant correlation with change of VAS score after rTMS.
  • fMRI showed significantly decreased activity in the secondary somatosensory cortex, insula, prefrontal cortex, and putamen in rTMS responders, whereas no change was noted in nonresponders.

Print Article Summary