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Effect of repetitive transcranial magnetic stimulation over the hand motor cortical area on central pain after spinal cord injury.
Arch Phys Med Rehabil. 2009 Oct; 90(10):1766-71.AP

Abstract

Kang BS, Shin HI, Bang MS. Effect of repetitive transcranial magnetic stimulation over the hand motor cortical area on central pain after spinal cord injury.

OBJECTIVE

To evaluate the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) applied on the hand motor cortical area in patients with spinal cord injury (SCI) who have chronic neuropathic pain at multiple sites in the body, including the lower limbs, trunk, and pelvis.

DESIGN

Blinded, randomized crossover study.

SETTING

University hospital outpatient setting.

PARTICIPANTS

Patients (N=13) with motor complete or incomplete SCI and chronic central pain (11 completed the study).

INTERVENTIONS

rTMS was applied on the hand motor cortical area using a figure-of-eight coil. One thousand stimuli were applied daily on 5 consecutive days. Real and sham rTMS were separated by 12 weeks.

MAIN OUTCOME MEASURES

Numeric rating scale (NRS) for average and worst pain and the Brief Pain Inventory (BPI).

RESULTS

At 1 week after the end of the rTMS period, the average NRS scores changed from 6.45+/-2.25 to 5.45+/-1.81 with real stimulation and from 6.18+/-1.83 to 5.91+/-2.07 with sham stimulation, and did not differ between treatments. The interference items of the BPI also did not differ between the real and sham rTMS. The effect of time on the NRS score for worst pain was significant with real stimulation but not with sham stimulation.

CONCLUSIONS

The therapeutic efficacy of rTMS was not demonstrated when rTMS was applied to the hand motor cortical area in patients with chronic neuropathic pain at multiple sites in the body, including the lower limbs, trunk, and pelvis. However, the results for worst pain reduction suggest that further studies are required in which rTMS is applied with a more intensive stimulation protocol.

Authors+Show Affiliations

Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, South Korea.No 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

19801069

Citation

Kang, Bo Sung, et al. "Effect of Repetitive Transcranial Magnetic Stimulation Over the Hand Motor Cortical Area On Central Pain After Spinal Cord Injury." Archives of Physical Medicine and Rehabilitation, vol. 90, no. 10, 2009, pp. 1766-71.
Kang BS, Shin HI, Bang MS. Effect of repetitive transcranial magnetic stimulation over the hand motor cortical area on central pain after spinal cord injury. Arch Phys Med Rehabil. 2009;90(10):1766-71.
Kang, B. S., Shin, H. I., & Bang, M. S. (2009). Effect of repetitive transcranial magnetic stimulation over the hand motor cortical area on central pain after spinal cord injury. Archives of Physical Medicine and Rehabilitation, 90(10), 1766-71. https://doi.org/10.1016/j.apmr.2009.04.008
Kang BS, Shin HI, Bang MS. Effect of Repetitive Transcranial Magnetic Stimulation Over the Hand Motor Cortical Area On Central Pain After Spinal Cord Injury. Arch Phys Med Rehabil. 2009;90(10):1766-71. PubMed PMID: 19801069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of repetitive transcranial magnetic stimulation over the hand motor cortical area on central pain after spinal cord injury. AU - Kang,Bo Sung, AU - Shin,Hyung Ik, AU - Bang,Moon Suk, PY - 2009/01/06/received PY - 2009/04/22/revised PY - 2009/04/27/accepted PY - 2009/10/6/entrez PY - 2009/10/6/pubmed PY - 2009/10/23/medline SP - 1766 EP - 71 JF - Archives of physical medicine and rehabilitation JO - Arch Phys Med Rehabil VL - 90 IS - 10 N2 - UNLABELLED: Kang BS, Shin HI, Bang MS. Effect of repetitive transcranial magnetic stimulation over the hand motor cortical area on central pain after spinal cord injury. OBJECTIVE: To evaluate the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) applied on the hand motor cortical area in patients with spinal cord injury (SCI) who have chronic neuropathic pain at multiple sites in the body, including the lower limbs, trunk, and pelvis. DESIGN: Blinded, randomized crossover study. SETTING: University hospital outpatient setting. PARTICIPANTS: Patients (N=13) with motor complete or incomplete SCI and chronic central pain (11 completed the study). INTERVENTIONS: rTMS was applied on the hand motor cortical area using a figure-of-eight coil. One thousand stimuli were applied daily on 5 consecutive days. Real and sham rTMS were separated by 12 weeks. MAIN OUTCOME MEASURES: Numeric rating scale (NRS) for average and worst pain and the Brief Pain Inventory (BPI). RESULTS: At 1 week after the end of the rTMS period, the average NRS scores changed from 6.45+/-2.25 to 5.45+/-1.81 with real stimulation and from 6.18+/-1.83 to 5.91+/-2.07 with sham stimulation, and did not differ between treatments. The interference items of the BPI also did not differ between the real and sham rTMS. The effect of time on the NRS score for worst pain was significant with real stimulation but not with sham stimulation. CONCLUSIONS: The therapeutic efficacy of rTMS was not demonstrated when rTMS was applied to the hand motor cortical area in patients with chronic neuropathic pain at multiple sites in the body, including the lower limbs, trunk, and pelvis. However, the results for worst pain reduction suggest that further studies are required in which rTMS is applied with a more intensive stimulation protocol. SN - 1532-821X UR - https://www.unboundmedicine.com/medline/citation/19801069/Effect_of_repetitive_transcranial_magnetic_stimulation_over_the_hand_motor_cortical_area_on_central_pain_after_spinal_cord_injury_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-9993(09)00372-4 DB - PRIME DP - Unbound Medicine ER -