title: rTMS of the prefrontal cortex has analgesic effects on neuropathic pain in subjects with spinal cord injury.
abstract: METHODS
  Repetitive transcranial magnetic stimulation study.
  
  
  OBJECTIVE
  The analgesic effects of repetitive transcranial magnetic stimulation (rTMS) in chronic pain have been the focus of several studies. In particular, rTMS of the premotor cortex/dorsolateral prefrontal cortex (PMC/DLPFC) changes pain perception in healthy subjects and has analgesic effects in acute postoperative pain, as well as in fibromyalgia patients. However, its effect on neuropathic pain in patients with traumatic spinal cord injury (SCI) has not been assessed.
  
  
  METHODS
  Merano (Italy) and Salzburg (Austria).
  
  
  METHODS
  In this study, we performed PMC/DLPFC rTMS in subjects with SCI and neuropathic pain. Twelve subjects with chronic cervical or thoracic SCI were randomized to receive 1250 pulses at 10 Hz rTMS (n=6) or sham rTMS (n=6) treatment for 10 sessions over 2 weeks. The visual analog scale, the sensory and affective pain rating indices of the McGill Pain Questionnaire (MPQ), the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale were used to assed pain and mood at baseline (T0), 1 day after the first week of treatment (T1), 1 day (T2), 1 week (T3) and 1 month (T4) after the last intervention.
  
  
  RESULTS
  Subjects who received active rTMS had a statistically significant reduction in pain symptoms in comparison with their baseline pain, whereas sham rTMS participants had a non-significant change in daily pain from their baseline pain.
  
  
  CONCLUSIONS
  The findings of this preliminary study in a small patient sample suggest that rTMS of the PMC/DLPFC may be effective in relieving neuropathic pain in SCI patients.
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria.|Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.|Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Nardone
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria.|Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Y
authors.initials: Y
authors.lastname: Höller
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria.|Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria.|Department of Mathematics, Paris Lodron University of Salzburg, Salzburg, Austria.
authors.forename: P B
authors.initials: PB
authors.lastname: Langthaler
authors.affiliation: Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.
authors.forename: P
authors.identifier: http://orcid.org/0000-0002-2101-6066
authors.initials: P
authors.lastname: Lochner
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria.|Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Golaszewski
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria.|Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Schwenker
authors.affiliation: Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.|Department of Neurological and Movement Sciences, University of Verona, Verona, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Brigo
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria.|Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Trinka
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002574:Cervical Vertebrae; D059350:Chronic Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology; D009437:Neuralgia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D013904:Thoracic Vertebrae; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome