Affiliations: Department of Clinical Neurophysiology, Georg-August
University, Göttingen, Germany
Note: [] Corresponding author: PD Dr. Andrea Antal, Department of
Clinical Neurophysiology, Georg-August University of Göttingen, Robert Koch
Straβe 40, 37075 Göttingen, Germany. Tel.: +49 551 398461; Fax: +49
551 398126; E-mail: AAntal@gwdg.de
Abstract: Transcranial stimulation of the primary motor cortex (M1) for the
treatment of pain has attracted much interest in recent years. Non-invasive low
frequency and high frequency repetitive transcranial magnetic stimulation
(rTMS) over the M1 was reported to reduce both experimentally induced acute and
chronic pain. In this paper we summarize the results of several studies from
our laboratory and report the antinociceptive effects of a special rTMS
paradigm, theta-burst stimulation (TBS). We have applied excitatory (iTBS) and
inhibitory (cTBS) paradigms over two cortical locations (M1 and the primary
somatosensory cortex (S1)). As evaluation criteria a pain rating scale and the
recording of laser evoked potentials (LEPs) were used. Reduced subjective pain
perception after cTBS could be objectified by alterations of LEPs that reflect
pain related activations in the pain processing in the operculo-insular and
anterior cingulate cortex. The stimulation of S1 had physiological effects
(LEPs), but did not induce significant reduction in acute pain perception. We
believe that the application of cTBS over M1 in pain research has a great
potential and as a method it can contribute to a more efficient manipulation of
the brain plasticity for therapeutic purposes, for example in chronic pain.
Nevertheless, the effectiveness of other types of TBS paradigms should also be
tested.
