Clinical study of high-frequency transcranial magnetic stimulation in thalamic pain
10.3760/cma.j.cn115354-20230601-00306
- VernacularTitle:高频经颅磁刺激治疗丘脑痛的临床研究
- Author:
Xu JIANG
1
;
Xiangyang TANG
;
Zuosheng CHEN
Author Information
1. 安徽医科大学第五临床医学院，合肥 230022
- Keywords:
High-frequency repetitive transcranial magnetic stimulation;
Thalamic pain;
Primary motor cortex;
Secondary sensory cortex
- From:
Chinese Journal of Neuromedicine
2023;22(9):899-903
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the short-term clinical efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in thalamic pain.Methods:A prospective study was performed; 41 patients with thalamic pain who received hrTMS in Department of Neurology, Anqing Medical Center Affiliated to Anhui Medical University from December 2022 to August 2023 were selected. According to different stimulation sites, these patients were divided into S2 group (intervening secondary sensory cortex of the unaffected side, n=21) and M1 group (intervening primary motor cortex of the unaffected side, n=20). Before treatment, at the 1 st weekend after pseudo-stimulation treatment and at the 1 st, 2 nd and 3 rd weeks after effective stimulation treatment, short-form McGill Pain Questionnaire (SF-MPQ) was performed, and N100 amplitude was monitored by myoelectric evoked potentiometer; adverse reactions during treatment cycles were observed. Results:(1) Compared with those before treatment, scores of sensory item, emotional item and visual analogue scale (VAS), and present pain intensity in S2 group were significantly decreased at the 2 nd and 3 rd weeks after effective stimulation treatment ( P<0.05). Compared with those before treatment, scores of sensory item and VAS, and present pain intensity in M1 group were significantly decreased at the 2 nd weeks after effective stimulation treatment, and scores of sensory item, emotional item and VAS, and present pain intensity in M1 group were significantly decreased at the 3 rd weeks after effective stimulation treatment( P<0.05). At the 3 rd weeks after effective stimulation treatment, compared with the M1 group, the S2 group had significantly decreased scores of sensory item, emotional item, and VAS, and present pain intensity (5.35±0.54 vs. 4.86±0.74; 3.55±0.69 vs. 3.14±0.57; 5.50±0.69 vs. 5.00±0.78; 2.20±0.42 vs. 1.81±0.41, P<0.05). (2) Compared with those before treatment, N100 amplitude in S2 group and M1 group was significantly increased at the 2 nd and 3 rd weeks after effective stimulation treatment ( P<0.05). At the 3 rd weeks after effective stimulation treatment, the S2 group had significantly higher N100 amplitude than the M1 group (3.43±0.60 vs. 3.00±0.65, P<0.05). (3) No adverse reactions such as seizure or scalp burning occurred in the 2 groups during the treatment cycles, without significant difference in headache or tinnitus incidences ( P>0.05). Conclusion:The hrTMS on secondary sensory cortex and primary motor cortex of the unaffected side can relief the short-term pain intensity in patients with thalamic pain, without obvious side effects; and hrTMS on secondary sensory cortex enjoys better effect.
