title: The Efficacy of Daily Prefrontal Repetitive Transcranial Magnetic Stimulation (rTMS) for Burning Mouth Syndrome (BMS): A Randomized Controlled Single-blind Study.
abstract: BACKGROUND
  Burning mouth syndrome (BMS) is a burning oral sensation without any corresponding abnormal findings. In some cases, BMS is refractory to pharmacologic treatments. Repetitive transcranial magnetic stimulation (rTMS) over left prefrontal cortex induces analgesic effect in both acute and chronic pain. However, its effect for BMS has not been evaluated.
  
  
  OBJECTIVE
  The aim of this randomized, controlled, single-blind study was to assess the efficacy of prefrontal rTMS for BMS.
  
  
  METHODS
  Twenty patients with BMS were recruited and randomized to receive 30,000 pulses in total at 10 Hz TMS (n = 12) or sham TMS (n = 8). We assessed the change of BMS pain condition, functional status and mood until 2 months after the beginning of treatment.
  
  
  RESULTS
  In the real group, the BMS pain intensity decreased 67%, and 75% of the patients reported >50% pain decrease on final assessment compared to baseline, without heavy side effects. There was significant pain reduction in subjects in the real group immediately after 1 week of treatment, whereas there was none in those in the sham group. Similar tendency was confirmed in change of functional status. Mood and the affective aspect of pain were not changed in this study.
  
  
  CONCLUSIONS
  BMS pain was significantly improved with 2 weeks of treatment of high frequency rTMS over left DLPFC compared to sham stimulation. Further study is needed to refine and improve TMS as a potential treatment of BMS.
authors.affiliation: Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA. Electronic address: umezaki@yahoo.com.
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Umezaki
authors.affiliation: Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA.
authors.forename: Bashar W
authors.initials: BW
authors.lastname: Badran
authors.affiliation: Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: DeVries
authors.affiliation: Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA.
authors.forename: Jkeonye
authors.initials: J
authors.lastname: Moss
authors.affiliation: Division of Oral Pathology, College of Dental Medicine, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC 29425, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Gonzales
authors.affiliation: Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, 109 Bee Street, Charleston, SC 29401, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: George
mesh_terms: D000339:Affect; D002054:Burning Mouth Syndrome / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D017397:Prefrontal Cortex / Q000503:physiopathology; D016037:Single-Blind Method; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Burning mouth syndrome; Chronic pain; Left dorsolateral prefrontal cortex; Repetitive transcranial magnetic stimulation