Efficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study

Although rare, central post-stroke pain remains one of the most refractory forms of neuropathic pain. Repetitive transcranial magnetic stimulation (rTMS) has been reported to be effective in chronic cases. However, there are no data on the effects in the acute and subacute phases after stroke. In th...

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Autores principales:	Calogero Malfitano, Angela Rossetti, Stefano Scarano, Chiara Malloggi, Luigi Tesio
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	thalamic stroke central post-stroke pain rTMS neuropathic pain cortical excitability rehabilitation Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ac7f4668695044ab8ac9cb43c4b18cab
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spelling	oai:doaj.org-article:ac7f4668695044ab8ac9cb43c4b18cab2021-11-11T04:57:44ZEfficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study1664-229510.3389/fneur.2021.742567https://doaj.org/article/ac7f4668695044ab8ac9cb43c4b18cab2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.742567/fullhttps://doaj.org/toc/1664-2295Although rare, central post-stroke pain remains one of the most refractory forms of neuropathic pain. Repetitive transcranial magnetic stimulation (rTMS) has been reported to be effective in chronic cases. However, there are no data on the effects in the acute and subacute phases after stroke. In this study, we present a case of a patient with thalamic stroke with acute onset of pain and paresthesia who was responsive to rTMS. After a right thalamic stroke, a 32-year-old woman presented with drug-resistant pain and paresthesia on the left side of the body. There were no motor or sensory deficits, except for blunted thermal sensation and allodynia on light touch. Ten daily sessions were performed, where 10 Hz rTMS was applied to the hand area of the right primary motor cortex, 40 days after stroke. Before rTMS treatment (T0), immediately after treatment conclusion (T1), and 1 month after treatment (T2), three pain questionnaires were administered, and cortical responses to single and paired-pulse TMS were assessed. Eight healthy participants served as controls. At T0, when the patient was experiencing the worst pain, the excitability of the ipsilesional motor cortex was reduced. At T1 and T2, the pain scores and paresthesia' spread decreased. The clinical improvement was paralleled by the recovery in motor cortex excitability of the affected hemisphere, in terms of both intra- and inter-hemispheric connections. In this subacute central post-stroke pain case, rTMS treatment was associated with decreased pain and motor cortex excitability changes.Calogero MalfitanoAngela RossettiStefano ScaranoStefano ScaranoChiara MalloggiLuigi TesioLuigi TesioFrontiers Media S.A.articlethalamic strokecentral post-stroke painrTMSneuropathic paincortical excitabilityrehabilitationNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	thalamic stroke central post-stroke pain rTMS neuropathic pain cortical excitability rehabilitation Neurology. Diseases of the nervous system RC346-429
spellingShingle	thalamic stroke central post-stroke pain rTMS neuropathic pain cortical excitability rehabilitation Neurology. Diseases of the nervous system RC346-429 Calogero Malfitano Angela Rossetti Stefano Scarano Stefano Scarano Chiara Malloggi Luigi Tesio Luigi Tesio Efficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study
description	Although rare, central post-stroke pain remains one of the most refractory forms of neuropathic pain. Repetitive transcranial magnetic stimulation (rTMS) has been reported to be effective in chronic cases. However, there are no data on the effects in the acute and subacute phases after stroke. In this study, we present a case of a patient with thalamic stroke with acute onset of pain and paresthesia who was responsive to rTMS. After a right thalamic stroke, a 32-year-old woman presented with drug-resistant pain and paresthesia on the left side of the body. There were no motor or sensory deficits, except for blunted thermal sensation and allodynia on light touch. Ten daily sessions were performed, where 10 Hz rTMS was applied to the hand area of the right primary motor cortex, 40 days after stroke. Before rTMS treatment (T0), immediately after treatment conclusion (T1), and 1 month after treatment (T2), three pain questionnaires were administered, and cortical responses to single and paired-pulse TMS were assessed. Eight healthy participants served as controls. At T0, when the patient was experiencing the worst pain, the excitability of the ipsilesional motor cortex was reduced. At T1 and T2, the pain scores and paresthesia' spread decreased. The clinical improvement was paralleled by the recovery in motor cortex excitability of the affected hemisphere, in terms of both intra- and inter-hemispheric connections. In this subacute central post-stroke pain case, rTMS treatment was associated with decreased pain and motor cortex excitability changes.
format	article
author	Calogero Malfitano Angela Rossetti Stefano Scarano Stefano Scarano Chiara Malloggi Luigi Tesio Luigi Tesio
author_facet	Calogero Malfitano Angela Rossetti Stefano Scarano Stefano Scarano Chiara Malloggi Luigi Tesio Luigi Tesio
author_sort	Calogero Malfitano
title	Efficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study
title_short	Efficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study
title_full	Efficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study
title_fullStr	Efficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study
title_full_unstemmed	Efficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study
title_sort	efficacy of repetitive transcranial magnetic stimulation for acute central post-stroke pain: a case study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/ac7f4668695044ab8ac9cb43c4b18cab
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Efficacy of Repetitive Transcranial Magnetic Stimulation for Acute Central Post-stroke Pain: A Case Study

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