scholarly journals Structural and functional biomarkers of efficacy of navigated repetitive transcranial magnetic stimulation in therapy for trigeminal neuralgia

2021 ◽  
Author(s):  
AG Poydasheva ◽  
DO Sinitsyn ◽  
IS Bakulin ◽  
NA Suponeva ◽  
MA Piradov
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Trigeminal Neuralgia ◽  
Pain Intensity ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Cerebellar Hemisphere ◽  
Average Pain Intensity ◽  
Postcentral Gyrus ◽  
Average Pain ◽  
Positive Correlations

Repetitive transcranial magnetic stimulation (rTMS) is an alternative treatment option for patients with drug-resistant trigeminal neuralgia (TN). However, the effect of rTMS is variable. The aim of this study was to find neuroimaging biomarkers of clinical efficacy of navigated rTMS. Seventeen patients with TN (14 women and 3 men, median age 56 years) received 10 sessions of high-frequency rTMS of the motor cortex contralateral to pain side. The data were analyzed for correlations between functional connectivity (FC), the grey matter (GM) volume and the reduction in pain intensity. Positive correlations were established between the reduction in average pain intensity and GM volume in caudate nuclei in both hemispheres (p(unc) = 0.03), both cerebellar hemispheres (p(unc) = 0.002) and the postcentral gyrus contralateral to pain side (p(unc) = 0.005); between the reduction in peak pain intensity and GM volume in the caudate nucleus contralateral to pain side (p(unc) = 0.04) and the cerebellar hemisphere ipsilateral to pain (p(unc) = 0.03). Significant positive correlations were discovered between the reduction in average pain intensity and FC between the thalamus contralateral to pain side, the postcentral gyrus and the insular operculum (both ipsilateral to pain side; (p(FWE) = 0.018), as well as between the cingulate cortex and the anterior cingulate cortex ipsilateral to pain (p(FWE) = 0.017), between the contralateral subcallosal gyrus and the cerebellar hemisphere ipsilateral to pain (p(FWE) = 0.018). A negative correlation was established for FC between the contralateral putamen and the occipital lobes in both hemispheres (p(FWE) = 0.001). Our findings may spur the development of individual predictors of rTMS efficacy in patients with chronic pain.

scholarly journals Repetitive transcranial magnetic stimulation as a prophylactic treatment in migraine

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Azza B. Hammad ◽  
Rasha E. Elsharkawy ◽  
Ghada S. Abdel Azim
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Serum Level ◽  
Pain Intensity ◽  
Magnetic Stimulation ◽  
Prophylactic Treatment ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Control Group ◽  
Neurokinin A ◽  
Abortive Treatment

Abstract Background Clinical applications of transcranial magnetic stimulation (TMS) have shown promising results in the treatment of headache disorders, with migraine being one of the most encountered. Objective To assess the role of low-frequency repetitive transcranial magnetic stimulation as a preventive treatment of migraine (with and without aura) and correlate the results with the serum level of the inflammatory biomarker (neurokinin A). Methods Forty patients, with age ranging from 15 to 55 years, diagnosed with migraine (30 migraine without aura and 10 with aura) and 20 apparently healthy individuals, who were age and sex matched with the patient group, were included in this study. A low-frequency (1 Hz) rTMS protocol was applied for all patients for five consecutive days interictally. Assessment of pain intensity using visual analogue scale and frequency and duration of attacks as well as number of pills taken by patients as an abortive treatment according to the Basic Diagnostic Headache Diary for 4 weeks before and 4 weeks after TMS sessions was done. In addition, the Migraine Disability Assessment scale (MIDAS) was applied to assess the severity and degree of disability caused by migraine. Measurement of neurokinin A serum level was done by using ELISA for all patients before and after TMS and for control group once. Results There was a significant reduction in pain intensity, frequency and duration of migraine attacks, migraine disability scores, and number of pills taken as abortive treatment for attacks after rTMS (P < 0.001). Also, serum level of neurokinin A in the patients was significantly reduced after rTMS (P < 0.001). Conclusion Low-frequency rTMS is an effective prophylactic treatment for migraine with and without aura.

Pain Psychiatry of Trigeminal Neuralgia

2018 ◽  
pp. 243-264
Author(s):  
Lily H. Kim ◽  
Michael Bret Schneider
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Depression And Anxiety ◽  
Surgical Interventions ◽  
Holistic Treatment ◽  
Carbamazepine Therapy ◽  
High Incidence

In addition to the repeated episodes of paroxysmal, electrical facial pain classically associated with the disease, many patients with trigeminal neuralgia (TN) suffer from severe emotional distress. At present, there is no universally agreed pathophysiological explanation for the high incidence of depression and anxiety within this patient population. Despite the unclear understanding, the psychiatric comorbidities should be addressed as a part of comprehensive, multi-modal approach. Anticonvulsants or serotonin and norepineprhine reuptake inhibitors are viable pharmacological options that can supplement the currently used carbamazepine therapy. For medically refractory cases, surgical interventions are being suggested as effective alternatives in managing both the pain and the psychiatric complaints of TN. Examples include microvascular decompression, stereotactic radiosurgery, and repetitive transcranial magnetic stimulation. Continued research to understand TN should take into account the psychiatric burden in this population in order to promote a holistic treatment approach.

Interference of Left and Right Cerebellar rTMS with Procedural Learning

2004 ◽  
Vol 16 (9) ◽  
pp. 1605-1611 ◽  
Author(s):  
Sara Torriero ◽  
Massimiliano Oliveri ◽  
Giacomo Koch ◽  
Carlo Caltagirone ◽  
Laura Petrosini
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Reaction Time Task ◽  
Normal Subjects ◽  
Serial Reaction Time Task ◽  
Procedural Learning ◽  
Cerebellar Hemisphere ◽  
Serial Reaction ◽  
The Right

Increasing evidence suggests cerebellar involvement in procedural learning. To further analyze its role and to assess whether it has a lateralized influence, in the present study we used a repetitive transcranial magnetic stimulation interference approach in a group of normal subjects performing a serial reaction time task. We studied 36 normal volunteers: 13 subjects underwent repetitive transcranial magnetic stimulation on the left cerebellum and performed the task with the right (6 subjects) or left (7 subjects) hand; 10 subjects underwent repetitive transcranial magnetic stimulation on the right cerebellum and performed the task with the hand ipsilateral (5 subjects) or contralateral (5 subjects) to the stimulation; another 13 subjects served as controls and were not submitted to repetitive transcranial magnetic stimulation; 7 of them performed the task with the right hand and 6 with the left hand. The main results show that interference with the activity of the lateral cerebellum induces a significant decrease of procedural learning: Interference with the right cerebellar hemisphere activity induces a significant decrease in procedural learning regardless of the hand used to perform the serial reaction time task, whereas left cerebellar hemisphere activity seems more linked with procedural learning through the ipsilateral hand. In conclusion, the present study shows for the first time that a transient interference with the functions of the cerebellar cortex results in an impairment of procedural learning in normal subjects and it provides new evidences for interhemispheric differences in the lateral cerebellum.

scholarly journals PENGARUH REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (r-TMS) TERHADAP INTENSITAS NYERI PENDERITA CENTRAL POST-STROKE PAIN (CPSP)

2018 ◽  
Vol 35 (4) ◽  
Author(s):  
Dody Perdana Goenadhi ◽  
Jumraini Tammasse ◽  
David Gunawan
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Pain Intensity ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Central Pain ◽  
Pain Rating ◽  
Post Stroke ◽  
Numerical Pain Rating Scale ◽  
Pain Rating Scale

  EFFECTS OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (r-TMS) TOWARDS PAIN INTENSITY IN PATIENTS WITH CENTRAL POST-STROKE PAIN (CPSP)ABSTRACTIntroduction: About 2,7% patients have experienced central post-stroke pain (CPSP) after stroke attack. Repetitive transcranial magnetic stimulation (r-TMS) is a nonpharmacological method to overcome CPSP.Aims: To determine the effectiveness of r-TMS to reduce pain intensity in patients with CPSP.Methods: Randomized-controlled trial in Wahidin Sudirohusodo hospital and Inggit clinic from December 2017 until May 2018. Subjects were divided to 2 groups; control, who received standard therapy for CPSP, and treatment, who received standard therapy for CPSP and r-TMS. Repetitive transcranial magnetic stimulation was done using 2000 pulse and 10Hz frequency. Pain intensity was measured with Numerical Pain Rating Scale (NPRS) at baseline, after r-TMS until day 10. Data analysis was done by Mann-Whitney test.Results: As much as 30 subjects were divided into 2 groups (15 control and 15 treatment). The difference in NPRS score after 10 days of treatment was statistically higher in the treatment group compared to the control (6,67 vs 4,67, p=0,002).Discussion: There was a significant reduction in pain intensity in the group given r-TMS for 10 cycles.Keywords: Central pain, NPRS, r-TMS, strokeABSTRAKPendahuluan: Sebanyak 2,7% pasien mengalami central post-stroke pain (CPSP) setelah serangan. Efektivitas repetitive transcranial magnetic stimulation (r-TMS) merupakan salah satu metoda nonfarmakologis untuk mengatasi CPSP.Tujun: Mengetahui efektivitas repetitive transcranial magnetic stimulation (r-TMS) terhadap penurunan intensitas nyeri pada penderita CPSP.Metode: Uji klinis terandomisasi di RSUP Dr. Wahidin Sudirohusodo dan Klinik Inggit dari Desember 2017 hingga Mei 2018. Subjek dibagi menjadi 2 kelompok, kelompok kontrol yang mendapat terapi standar dan kelompok perlakuan yang ditambahkan r-TMS. Repetitive transcranial magnetic stimulation dilakukan sebanyak 2000 pulse dengan frekuensi 10Hz. Nyeri diukur dengan Numerical Pain Rating Scale (NPRS) sebelum dan pascaterapi hingga hari ke-10. Analisis data dilakukan dengan uji Mann-Whitney.Hasil: Didapatkan 30 subjek yang dibagi menjadi 2 kelompok (15 kontrol dan 15 perlakuan). Selisih skor NPRS setelah sepuluh hari terapi lebih besar secara signifikan pada kelompok perlakuan dibandingkan dengan kontrol (6,67 vs 4,67, p=0,002).Diskusi: Terdapat penurunan intensitas nyeri yang signifikan pada kelompok yang diberikan r-TMS selama 10 siklus.Kata kunci: Central pain, NPRS, stroke, r-TMS

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