Right secondary somatosensory cortex—a promising novel target for the treatment of drug-resistant neuropathic orofacial pain with repetitive transcranial magnetic stimulation
| Autor: | Tero Taiminen, Jarmo Hietala, Antti Pertovaara, Salla Lamusuo, Nora Hagelberg, Riitta Parkkola, Arja Virtanen, Ullamari Pesonen, Ari Lahti, Pauliina Lindholm, Satu K. Jääskeläinen, Heli Forssell |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Orofacial pain medicine.medical_treatment Stimulation Somatosensory system Placebo ta3112 Facial Pain medicine Humans Single-Blind Method Brief Pain Inventory Aged Pain Measurement Cross-Over Studies Secondary somatosensory cortex ta1184 Somatosensory Cortex Middle Aged Transcranial Magnetic Stimulation Transcranial magnetic stimulation Treatment Outcome Anesthesiology and Pain Medicine medicine.anatomical_structure Neurology Anesthesia Female Neurology (clinical) medicine.symptom Psychology Motor cortex |
| Zdroj: | Pain. 156:1276-1283 |
| ISSN: | 0304-3959 |
| Popis: | High-frequency repetitive transcranial magnetic stimulation (rTMS) of the motor cortex has analgesic effect; however, the efficacy of other cortical targets and the mode of action remain unclear. We examined the effects of rTMS in neuropathic orofacial pain, and compared 2 cortical targets against placebo. Furthermore, as dopaminergic mechanisms modulate pain responses, we assessed the influence of the functional DRD2 gene polymorphism (957C>T) and the catechol-O-methyltransferase (COMT) Val158Met polymorphism on the analgesic effect of rTMS. Sixteen patients with chronic drug-resistant neuropathic orofacial pain participated in this randomized, placebo-controlled, crossover study. Navigated high-frequency rTMS was given to the sensorimotor (S1/M1) and the right secondary somatosensory (S2) cortices. All subjects were genotyped for the DRD2 957C>T and COMT Val158Met polymorphisms. Pain, mood, and quality of life were monitored throughout the study. The numerical rating scale pain scores were significantly lower after the S2 stimulation than after the S1/M1 (P = 0.0071) or the sham (P = 0.0187) stimulations. The Brief Pain Inventory scores were also lower 3 to 5 days after the S2 stimulation than those at pretreatment baseline (P = 0.0127 for the intensity of pain and P = 0.0074 for the interference of pain) or after the S1/M1 (P = 0.001 and P = 0.0001) and sham (P = 0.0491 and P = 0.0359) stimulations. No correlations were found between the genetic polymorphisms and the analgesic effect in the present small clinical sample. The right S2 cortex is a promising new target for the treatment of neuropathic orofacial pain with high-frequency rTMS. |
| Databáze: | OpenAIRE |
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