Transcranial magnetic stimulation in subjects with phantom pain and non-painful phantom sensations: A systematic review.

Transcranial magnetic stimulation in subjects with phantom pain and non-painful phantom sensations: A systematic review.
Brain Res Bull. 2019 Mar 09;148:1-9
Authors: Nardone R, Versace V, Sebastianelli L, Brigo F, Christova M, Scarano GI, Saltuari L, Trinka E, Hauer L, Sellner J
Abstract
Several studies have applied transcranial magnetic stimulation (TMS) in the attempt to further explore the pathophysiological mechanisms of phantom-limb pain (PLP) and non-painful phantom sensations (PS). We performed a systematic review of available evidence of this emerging technology in this indication. We identified studies which report a reduced intracortical inhibition and increased intracortical facilitation in the hemisphere contralateral to the PLP. TMS mapping revealed a significant lateralization of the center of gravity and an enlargement of the excitable area on the hemisphere contralateral to the amputation. N-Methyl-d-Aspartate-mediated mechanisms influence the changes of intracortical inhibition and facilitation occurring after limb amputation; however, these cortical excitability changes and PLP are independent of each other. TMS can also influence brain function if applied repetitively. A few studies have begun to therapeutically use repetitive TMS (rTMS) to relief PLP and non-painful PS. rTMS of the contralateral parietal cortex lead to a transient reduction in pain intensity. High frequency rTMS applied over the contralateral moto...

Source: Brain Research Bulletin - March 8, 2019 Category: Neurology Authors: Nardone R, Versace V, Sebastianelli L, Brigo F, Christova M, Scarano GI, Saltuari L, Trinka E, Hauer L, Sellner J Tags: Brain Res Bull Source Type: research