Robot-Guided Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Central Neuropathic Pain

Archives of Physical Medicine and Rehabilitation
Charles QuesadaR Peyron

Abstract

To confirm and extend previous results involving repetitive transcranial magnetic stimulation (rTMS) aimed at alleviating refractory central neuropathic pain (CNP). To evaluate pain relief in detail and to assess ongoing benefits after one year of treatment. Prospective observational study. University hospital. Outpatient settings. Patients (N=80) with chronic central pain after brain or spinal cord injuries. High-frequency (20Hz) neuronavigated-rTMS sessions were applied on the primary motor cortex using a figure-of-eight coil positioned by a robotized arm. Patients received a minimum of 4 consecutive sessions, each separated by 3-4 weeks. Percentage of pain relief (%R), duration of pain relief (DPR), numeric rating scale (NRS), neuropathic pain symptom inventory (NPSI), and pain relief score (PRS). Seventy-one patients completed the study. On average, after the first 4 sessions, %R was 28% and DPR was 11 days. Fifty-four patients (76%) were responders with a permissive threshold of ≥10%R and 61% (43 patients) with a stringent threshold ≥30%R. After 12 months of treatment (15 sessions) we observed a cumulative effect on %R (48%), DPR (20d), and on the prevailing NPSI sub-score (-28%). This effect reached significance after 4 s...Continue Reading

Citations

Mar 27, 2020·Neuromodulation : Journal of the International Neuromodulation Society·Albert LeungUNKNOWN and the Expert Consensus Panel
Oct 23, 2019·Journal of Neural Transmission·X MoissetD Fontaine
May 8, 2019·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Luis Garcia-LarreaNathalie André-Obadia
Jan 22, 2021·Neuromodulation : Journal of the International Neuromodulation Society·Nobuhiko MoriYouichi Saitoh
Jan 7, 2020·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Jean-Pascal LefaucheurUlf Ziemann
Nov 28, 2020·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Simone RossiUNKNOWN basis of this article began with a Consensus Statement from the IFCN Workshop on "Present, Future of TMS: Safety, Ethical Gu
May 22, 2020·Neurophysiologie clinique = Clinical neurophysiology·Benjamin PommierFrançois Vassal
Aug 4, 2019·Neurophysiologie clinique = Clinical neurophysiology·Jean-Pascal Lefaucheur, Jean-Paul Nguyen
May 11, 2020·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Hasan HodajJean-Pascal Lefaucheur

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