Reduction of intractable deafferentation pain due to spinal cord or peripheral lesion by high-frequency repetitive transcranial magnetic stimulation of the primary motor cortex
Reduction of intractable deafferentation pain due to spinal cord or peripheral lesion by high-frequency repetitive transcranial magnetic stimulation of the primary motor cortex
复制标题
DOI：
10.3171/jns-07/09/0555
复制
发表时间：
2007-09-01
影响因子：
4.1
通讯作者：
Yoshimine, Tostm
中科院分区：
文献类型：
--
作者：
Saitoh, Youichi;Hirayama, Azuma;Yoshimine, Tostm
物体。作者先前曾报道，导航引导的中央前回重复经颅磁刺激(RTMS)可以缓解去传入疼痛。刺激参数为10串10秒5-HzTMS脉冲，间隔50秒。在目前的研究中，他们使用了不同的刺激频率，并比较了两种类型的病变之间的疗效。患者被分成两组：脑损害组和非脑损害组。所有患者均按随机顺序进行rTMS，频率分别为1、5、10赫兹。患者使用视觉模拟评分对rTMS的疼痛效果进行评分。与假刺激相比，频率为5和10赫兹的rTMS可显著减轻疼痛，且持续时间为180分钟。10赫兹的刺激频率可能比5赫兹更有效，而1赫兹的刺激频率无效。频率为5和10赫兹的rTMS对非脑部病变患者的影响大于脑部病变患者。高频(5-或10-赫兹)中央前回rTMS可以减轻顽固性去传入疼痛，但低频刺激(1赫兹)不能。有非脑损害的患者更适合进行中央前回高频rTMS。
Object. The 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.Methods. Patients 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.Results. The 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 I 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.Conclusions. High-frequency (5- or 10-Hz) rTMS of the precentral gyrus can reduce intractable deafferentation pain, but low-frequency stimulation (at I Hz) cannot. Patients with a noncerebral lesion are more suitable candidates for high-frequency rTMS of the precentral gyrus.