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The effect of a series of repetitive transcranial magnetic stimulations of the motor cortex on central pain after spinal cord injury.
Arch Phys Med Rehabil. 2007 Dec; 88(12):1574-80.AP

Abstract

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+Show Affiliations

Department of Physical Therapy, Sackler Medical School, Tel-Aviv University, Ramat Aviv, Israel. rutidef@post.tau.ac.ilNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18047871

Citation

Defrin, Ruth, et al. "The Effect of a Series of Repetitive Transcranial Magnetic Stimulations of the Motor Cortex On Central Pain After Spinal Cord Injury." Archives of Physical Medicine and Rehabilitation, vol. 88, no. 12, 2007, pp. 1574-80.
Defrin R, Grunhaus L, Zamir D, et al. The effect of a series of repetitive transcranial magnetic stimulations of the motor cortex on central pain after spinal cord injury. Arch Phys Med Rehabil. 2007;88(12):1574-80.
Defrin, R., Grunhaus, L., Zamir, D., & Zeilig, G. (2007). The effect of a series of repetitive transcranial magnetic stimulations of the motor cortex on central pain after spinal cord injury. Archives of Physical Medicine and Rehabilitation, 88(12), 1574-80.
Defrin R, et al. The Effect of a Series of Repetitive Transcranial Magnetic Stimulations of the Motor Cortex On Central Pain After Spinal Cord Injury. Arch Phys Med Rehabil. 2007;88(12):1574-80. PubMed PMID: 18047871.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of a series of repetitive transcranial magnetic stimulations of the motor cortex on central pain after spinal cord injury. AU - Defrin,Ruth, AU - Grunhaus,Leon, AU - Zamir,Doron, AU - Zeilig,Gabi, PY - 2007/04/10/received PY - 2007/06/11/revised PY - 2007/07/06/accepted PY - 2007/12/1/pubmed PY - 2007/12/12/medline PY - 2007/12/1/entrez SP - 1574 EP - 80 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 88 IS - 12 N2 - 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. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/18047871/The_effect_of_a_series_of_repetitive_transcranial_magnetic_stimulations_of_the_motor_cortex_on_central_pain_after_spinal_cord_injury_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(07)01452-9 DB - PRIME DP - Unbound Medicine ER -