Theta-Burst Stimulation of Forearm Muscles in Patients With Complex Regional Pain Syndrome: Influence on Brain and Clinical Outcomes
Objective: Complex regional pain syndrome (CRPS) is a common pain condition characterized by the changes in the brain that are not yet addressed by conventional treatment regimens. Repetitive peripheral magnetic stimulation (rPMS) of muscles is painless and non-invasive and can influence these chang...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Pain Research |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpain.2021.736806/full |
| _version_ | 1819129613365805056 |
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| author | Fannie Allen Demers Fannie Allen Demers Fannie Allen Demers Andrea Zangrandi Andrea Zangrandi Andrea Zangrandi Cyril Schneider Cyril Schneider Cyril Schneider Cyril Schneider |
| author_facet | Fannie Allen Demers Fannie Allen Demers Fannie Allen Demers Andrea Zangrandi Andrea Zangrandi Andrea Zangrandi Cyril Schneider Cyril Schneider Cyril Schneider Cyril Schneider |
| author_sort | Fannie Allen Demers |
| collection | DOAJ |
| description | Objective: Complex regional pain syndrome (CRPS) is a common pain condition characterized by the changes in the brain that are not yet addressed by conventional treatment regimens. Repetitive peripheral magnetic stimulation (rPMS) of muscles is painless and non-invasive and can influence these changes (the induction of brain plasticity) to reduce pain and improve motricity. In patients with CRPS, this open-label pilot study tested rPMS after-effects on the pain intensity and sensorimotor control of the upper limb along with the excitability changes of the primary motor cortex (M1).Methods: Eight patients with CRPS were enrolled in a single-session program. Patients were tested at pre- and post-rPMS over the flexor digitorum superficialis (FDS) muscle. The clinical outcomes were pain intensity, proprioception, active range of motion (ROM), and grip strength. M1 excitability was tested using the single- and paired-pulse transcranial magnetic stimulation (TMS) of M1.Results: In our small sample study, rPMS reduced instant and week pain, improved proprioception and ROM, and reduced the hemispheric imbalance of several TMS outcomes. The more M1 contralateral to the CRPS side was hyperactivated at baseline, the more pain was reduced.Discussion: This open-label pilot study provided promising findings for the use of rPMS in CRPS with a focus on M1 plastic changes. Future randomized, placebo-controlled clinical trials should confirm the existence of a causal relationship between the TMS outcomes and post-rPMS decrease of pain. This will favor the development of personalized treatments of peripheral non-invasive neurostimulation in CRPS. |
| first_indexed | 2024-12-22T08:46:30Z |
| format | Article |
| id | doaj.art-8568b7ec2cac4e34bf832565b3e8b4ad |
| institution | Directory Open Access Journal |
| issn | 2673-561X |
| language | English |
| last_indexed | 2024-12-22T08:46:30Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pain Research |
| spelling | doaj.art-8568b7ec2cac4e34bf832565b3e8b4ad2022-12-21T18:32:06ZengFrontiers Media S.A.Frontiers in Pain Research2673-561X2021-09-01210.3389/fpain.2021.736806736806Theta-Burst Stimulation of Forearm Muscles in Patients With Complex Regional Pain Syndrome: Influence on Brain and Clinical OutcomesFannie Allen Demers0Fannie Allen Demers1Fannie Allen Demers2Andrea Zangrandi3Andrea Zangrandi4Andrea Zangrandi5Cyril Schneider6Cyril Schneider7Cyril Schneider8Cyril Schneider9Noninvasive Stimulation Laboratory (NovaStim), Quebec City, QC, CanadaNeuroscience Division of Centre de Recherche du CHU of Québec – Université Laval, Quebec City, QC, CanadaFaculty of Medicine, Université Laval, Quebec City, QC, CanadaNoninvasive Stimulation Laboratory (NovaStim), Quebec City, QC, CanadaNeuroscience Division of Centre de Recherche du CHU of Québec – Université Laval, Quebec City, QC, CanadaFaculty of Medicine, Université Laval, Quebec City, QC, CanadaNoninvasive Stimulation Laboratory (NovaStim), Quebec City, QC, CanadaNeuroscience Division of Centre de Recherche du CHU of Québec – Université Laval, Quebec City, QC, CanadaFaculty of Medicine, Université Laval, Quebec City, QC, CanadaDepartment of Rehabilitation, Université Laval, Quebec City, QC, CanadaObjective: Complex regional pain syndrome (CRPS) is a common pain condition characterized by the changes in the brain that are not yet addressed by conventional treatment regimens. Repetitive peripheral magnetic stimulation (rPMS) of muscles is painless and non-invasive and can influence these changes (the induction of brain plasticity) to reduce pain and improve motricity. In patients with CRPS, this open-label pilot study tested rPMS after-effects on the pain intensity and sensorimotor control of the upper limb along with the excitability changes of the primary motor cortex (M1).Methods: Eight patients with CRPS were enrolled in a single-session program. Patients were tested at pre- and post-rPMS over the flexor digitorum superficialis (FDS) muscle. The clinical outcomes were pain intensity, proprioception, active range of motion (ROM), and grip strength. M1 excitability was tested using the single- and paired-pulse transcranial magnetic stimulation (TMS) of M1.Results: In our small sample study, rPMS reduced instant and week pain, improved proprioception and ROM, and reduced the hemispheric imbalance of several TMS outcomes. The more M1 contralateral to the CRPS side was hyperactivated at baseline, the more pain was reduced.Discussion: This open-label pilot study provided promising findings for the use of rPMS in CRPS with a focus on M1 plastic changes. Future randomized, placebo-controlled clinical trials should confirm the existence of a causal relationship between the TMS outcomes and post-rPMS decrease of pain. This will favor the development of personalized treatments of peripheral non-invasive neurostimulation in CRPS.https://www.frontiersin.org/articles/10.3389/fpain.2021.736806/fullCRPSrPMSTMSchronic painplasticityneurostimulation |
| spellingShingle | Fannie Allen Demers Fannie Allen Demers Fannie Allen Demers Andrea Zangrandi Andrea Zangrandi Andrea Zangrandi Cyril Schneider Cyril Schneider Cyril Schneider Cyril Schneider Theta-Burst Stimulation of Forearm Muscles in Patients With Complex Regional Pain Syndrome: Influence on Brain and Clinical Outcomes Frontiers in Pain Research CRPS rPMS TMS chronic pain plasticity neurostimulation |
| title | Theta-Burst Stimulation of Forearm Muscles in Patients With Complex Regional Pain Syndrome: Influence on Brain and Clinical Outcomes |
| title_full | Theta-Burst Stimulation of Forearm Muscles in Patients With Complex Regional Pain Syndrome: Influence on Brain and Clinical Outcomes |
| title_fullStr | Theta-Burst Stimulation of Forearm Muscles in Patients With Complex Regional Pain Syndrome: Influence on Brain and Clinical Outcomes |
| title_full_unstemmed | Theta-Burst Stimulation of Forearm Muscles in Patients With Complex Regional Pain Syndrome: Influence on Brain and Clinical Outcomes |
| title_short | Theta-Burst Stimulation of Forearm Muscles in Patients With Complex Regional Pain Syndrome: Influence on Brain and Clinical Outcomes |
| title_sort | theta burst stimulation of forearm muscles in patients with complex regional pain syndrome influence on brain and clinical outcomes |
| topic | CRPS rPMS TMS chronic pain plasticity neurostimulation |
| url | https://www.frontiersin.org/articles/10.3389/fpain.2021.736806/full |
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