Effect and reliability of Transcranial Magnetic Stimulation on neuropathic pain, depressive symptoms in stroke patients: Preliminary Study

Türkan Turgay,Neytullah Turan,Mazlum Serdar Akaltun,Özlem Altındağ,Şengül Kocamer Şahin

doi:10.17546/msd.532449

Abstract

Objective: In this paper, we aimed to evaluate the effect of repetitive Transcranial Magnetic Stimulation (rTMS) on central pain in patients with stroke. Material and Methods: Ten patients who had a stroke history were included in this preliminary study. Patients with middle cerebral artery lesion, first-time stroke, subacute or chronic lesion and no other neurological involvement were included. Patients were examined before and after the first month of treatment with repetitive Transcranial Magnetic Stimulation (rTMS). Visual Analog Scale (VAS) was used for pain scale measurement; Leeds Assessment of Neuropathic Symptoms and Signs Scale (LANSS) and Douleur Neuropathique en 4 Questions (DN4) were used for neuropathic pain level and Beck Depression Inventory (BDI) for depressive mood. All patients received the current treatments and appropriate neurorehabilitation as recommended for the treatment of ischemic stroke Results: This prospective study included a total of 10 post-stroke patients (mean age 58.2 ± 16.1 years; range 29 to 75, 8 male; 2 female) with neuropathic pain. The mean values of VAS, LANSS, DN4 and BDI scales were significantly decreased after rTMS treatment in all patients. Conclusion: We discussed the preliminary results of the efficacy and safety of rTMS in the treatment of uncontrolled neuropathic pain. We consider that, rTMS may have significant effect on relief of chronic pain. These clinical parameters can be utilized for the further study of rTMS application in pain control.

Highlights

Stroke is a major cause of death and disability
We discussed the preliminary results of the efficacy and safety of repetitive Transcranial Magnetic Stimulation (rTMS) in the treatment of uncontrolled neuropathic pain
RTMS may have significant effect on relief of chronic pain. These clinical parameters can be utilized for the further study of rTMS application in pain control

Summary

Introduction

Stroke is a major cause of death and disability. Survivors have typically neurological squeal and strokerelated complications. The duration of stroke rehabilitation depends on the severity of stroke and related complications. Pain is one of the most common complications in patients with stroke and may adversely affect patients’ quality of life [1]. Tricyclic antidepressants or anticonvulsants have been found to be useful for the treatment of neuropathic pain in stroke patients [2]. Despite various clinical trials there is still no consensus about the best strategies for the management of neuropathic pain [3]. The other safer and non-invasive way to provide analgesic neurostimulation is Transcranial Magnetic Stimulation (TMS)

Methods

Results

Discussion

Conclusion