Repetitive Transcranial Magnetic Stimulation for Phantom Limb Pain in Land Mine Victims: A Double-Blinded, Randomized, Sham-Controlled Trial




Curated By TMS Solutions on Sep 18, 2017 1:18:00 AM
Curated By TMS Solutions

TITLE
Repetitive Transcranial Magnetic Stimulation for Phantom Limb Pain in Land Mine Victims: A Double-Blinded, Randomized, Sham-Controlled Trial

AUTHORS
Malavera A; Silva FA; Fregni F; Carrillo S; Garcia RG. Institution Malavera, Alejandra. Neurovascular Science Group, Fundacion Cardiovascular de Colombia, Floridablanca, Colombia; Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts. Silva, Federico Arturo. Neurovascular Science Group, Fundacion Cardiovascular de Colombia, Floridablanca, Colombia. Fregni, Felipe. Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts. Carrillo, Sandra. Neurovascular Science Group, Fundacion Cardiovascular de Colombia, Floridablanca, Colombia. Garcia, Ronald G. Neurovascular Science Group, Fundacion Cardiovascular de Colombia, Floridablanca, Colombia; MASIRA Research Institute, School of Medicine, Universidad de Santander, Bucaramanga, Colombia; Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

ELECTRONIC ADDRESS
rgarcia@nmr.mgh.harvard.edu

SOURCE
Journal of Pain. 17(8):911-8, 2016 Aug.

ABSTRACT UNLABELLED
We evaluated the effects of repetitive transcranial magnetic stimulation (rTMS) in the treatment of phantom limb pain (PLP) in land mine victims. Fifty-four patients with PLP were enrolled in a randomized, double-blinded, placebo-controlled, parallel group single-center trial. The intervention consisted of real or sham rTMS of M1 contralateral to the amputated leg. rTMS was given in series of 20 trains of 6-second duration (54-second intertrain, intensity 90% of motor threshold) at a stimulation rate of 10 Hz (1,200 pulses), 20 minutes per day, during 10 days. For the control group, a sham coil was used. The administration of active rTMS induced a significantly greater reduction in pain intensity (visual analogue scale scores) 15 days after treatment compared with sham stimulation (-53.38 +/- 53.12% vs -22.93 +/- 57.16%; mean between-group difference = 30.44%, 95% confidence interval, .30-60.58; P = .03). This effect was not significant 30 days after treatment. In addition, 19 subjects (70.3%) attained a clinically significant pain reduction (>30%) in the active group compared with 11 in the sham group (40.7%) 15 days after treatment (P = .03). The administration of 10 Hz rTMS on the contralateral primary motor cortex for 2 weeks in traumatic amputees with PLP induced significant clinical improvement in pain.

PERSPECTIVE
High-frequency rTMS on the contralateral primary motor cortex of traumatic amputees induced a clinically significant pain reduction up to 15 days after treatment without any major secondary effect. These results indicate that rTMS is a safe and effective therapy in patients with PLP caused by land mine explosions.

Copyright © 2016

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Topics: Pain


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