Transcranial magnetic stimulation relieves pain and improves cortical excitability after stroke / 中华物理医学与康复杂志

ABSTRACT

Objective To investigate the effect of repeatedly applying transcranial magnetic stimulation (rTMS) in treating post-stroke pain (CPSP).Methods Forty stroke survivors experiencing CPSP were randomly divided into a treatment group and a control group,each of 20.All of the patients received conventional rehabilitation.In the treatment group,20 patients received 10 Hz rTMS at 80％ of their resting motor threshold applied over the primary motor cortex on their affected side,while those in the control group received sham stimulation.Both groups were treated once a day,6 times a week for 4 weeks.Before and after the treatment,both groups were assessed using a pain score self-assessed on a visual analogue scale (VAS).Their resting motor thresholds (RMTs),cortical silent periods (CSPs) and motor evoked potentials (MEPs) were also recorded.Results After the intervention,the average VAS score,RMT,CSP and M EP latency of the treatment group were (3.1±1.2),(51.3±4.8)％,(188.9± 63.0) ms and (27.9±5.7)ms,all significantly better than those before the intervention [(5.1± 1.3),(60.1±5.9)％,(239.7±43.5) ms and (35.5±4.4)ms] (P＜0.05).They were also significantly better than those of the control group after the intervention [(4.7±1.0),(57.6±5.1)％,(241.7±33.9)ms and (31.7±5.2)ms] (P＜0.05).Conclusion Transcranial magnetic stimulation can relieve post-stroke pain.The mechanisms might be related to positive changes in cortical excitability in the affected hemisphere.