Archives of physical medicine and rehabilitation · 2007
The effect of a series of repetitive transcranial magnetic stimulations of the motor cortex on central pain after spinal cord injury.
СтатьяРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Defrin Ruth, Grunhaus Leon, Zamir Doron, Zeilig Gabi
Аннотация
OBJECTIVE: To study the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) of the motor cortex on central pain in patients with chronic spinal cord injury (SCI).
DESIGN: Double-blind randomized controlled trial. Mean follow-up period was 4.5 weeks.
SETTING: General hospital.
PARTICIPANTS: Twelve paraplegic patients due to thoracic SCI suffering chronic central pain (11 completed the study) who were randomly selected from a list of eligible patients.
INTERVENTION: Real or sham 10 daily motor rTMS treatments (500 trains at 5 Hz for 10 s; total of 500 pulses at intensity of 115% of motor threshold) using figure-of-8 coil over the vertex.
MAIN OUTCOME MEASURES: Chronic pain intensity (visual analog scale [VAS], McGill Pain Questionnaire [MPQ]), pain threshold, and level of depression (Beck Depression Inventory).
RESULTS: Both real and sham TMS induced a similar, significant reduction in VAS scores (P<.001) immediately after each of the 10 treatment sessions and in VAS and MPQ scores after the end of the treatment series. However, only real rTMS conferred a significant increase in heat-pain threshold (4 degrees C, P<.05) by the end of the series. Most important, the reduction in MPQ scores in the real rTMS group continued during the follow-up period. Depression scores were equally reduced in both groups but similar to pain relief, depression continued to improve at follow-up in the real rTMS group.
CONCLUSIONS: Whereas the pain alleviation induced by a single rTMS treatment is probably due to placebo, patients with SCI may benefit from a series of rTMS treatments.
DESIGN: Double-blind randomized controlled trial. Mean follow-up period was 4.5 weeks.
SETTING: General hospital.
PARTICIPANTS: Twelve paraplegic patients due to thoracic SCI suffering chronic central pain (11 completed the study) who were randomly selected from a list of eligible patients.
INTERVENTION: Real or sham 10 daily motor rTMS treatments (500 trains at 5 Hz for 10 s; total of 500 pulses at intensity of 115% of motor threshold) using figure-of-8 coil over the vertex.
MAIN OUTCOME MEASURES: Chronic pain intensity (visual analog scale [VAS], McGill Pain Questionnaire [MPQ]), pain threshold, and level of depression (Beck Depression Inventory).
RESULTS: Both real and sham TMS induced a similar, significant reduction in VAS scores (P<.001) immediately after each of the 10 treatment sessions and in VAS and MPQ scores after the end of the treatment series. However, only real rTMS conferred a significant increase in heat-pain threshold (4 degrees C, P<.05) by the end of the series. Most important, the reduction in MPQ scores in the real rTMS group continued during the follow-up period. Depression scores were equally reduced in both groups but similar to pain relief, depression continued to improve at follow-up in the real rTMS group.
CONCLUSIONS: Whereas the pain alleviation induced by a single rTMS treatment is probably due to placebo, patients with SCI may benefit from a series of rTMS treatments.