Article

OBJECTIVE: To review the literature on the analgesic effects of repetitive
transcranial magnetic stimulation (rTMS) in chronic pain according to different
pain syndromes and stimulation parameters. DATA SOURCES: Publications on rTMS and
chronic pain were searched in PubMed and Google Scholar using the following key
words: chronic pain, analgesia, transcranial magnetic stimulation, neuropathic
pain, fibromyalgia, and complex regional pain syndrome.
STUDY SELECTION: This
review only included double-blind, controlled studies with >10 participants in
each arm that were published from 1996 to 2014 and written in English. Studies
with relevant information for the understanding of the effects of rTMS were also
cited. DATA EXTRACTION: The following data were retained: type of pain syndrome,
type of study, coil type, target, stimulation intensity, frequency, number of
pulses, orientation of induced current, number of session, and a brief summary of
intervention outcomes. DATA SYNTHESIS: A total of 33 randomized trials were
found. Many studies reported significant pain relief by rTMS, especially
high-frequency stimulation over the primary motor cortex performed in consecutive
treatment sessions. Pain relief was frequently >30% compared with control
treatment. Neuropathic pain, fibromyalgia, and complex regional pain syndrome
were the pain syndromes more frequently studied. However, among all published
studies, only a few performed repetitive sessions of rTMS. CONCLUSIONS: rTMS has
potential utility in the management of chronic pain; however, studies using
maintenance sessions of rTMS and assessing the effects of rTMS on the different
aspects of chronic pain are needed to provide a more solid basis for its clinical
application for pain relief.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS