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Journal of neurosurgery · Sep 2007
Randomized Controlled TrialReduction of intractable deafferentation pain due to spinal cord or peripheral lesion by high-frequency repetitive transcranial magnetic stimulation of the primary motor cortex.
- Youichi Saitoh, Azuma Hirayama, Haruhiko Kishima, Toshio Shimokawa, Satoru Oshino, Masayuki Hirata, Naoki Tani, Amami Kato, and Toshiki Yoshimine.
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita-shi, Japan. neurosaitoh@mbk.nifty.com
- J. Neurosurg. 2007 Sep 1;107(3):555-9.
ObjectThe authors previously reported that navigation-guided repetitive transcranial magnetic stimulation (rTMS) of the precentral gyrus relieves deafferentation pain. Stimulation parameters were 10 trains of 10-second 5-Hz TMS pulses at 50-second intervals. In the present study, they used various stimulation frequencies and compared efficacies between two types of lesions.MethodsPatients were divided into two groups: those with a cerebral lesion and those with a noncerebral lesion. The rTMS was applied to all the patients at frequencies of 1, 5, and 10 Hz and as a sham procedure in random order. The effect of rTMS on pain was rated by patients using a visual analog scale.ResultsThe rTMS at frequencies of 5 and 10 Hz, compared with sham stimulation, significantly reduced pain, and the pain reduction continued for 180 minutes. A stimulation frequency of 10 Hz may be more effective than 5 Hz, and at 1 Hz was ineffective. The effect of rTMS at frequencies of 5 and 10 Hz was greater in patients with a noncerebral lesion than those with a cerebral lesion.ConclusionsHigh-frequency (5- or 10-Hz) rTMS of the precentral gyrus can reduce intractable deafferentation pain, but low-frequency stimulation (at 1 Hz) cannot. Patients with a noncerebral lesion are more suitable candidates for high-frequency rTMS of the precentral gyrus.
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