Neuronavigated Repetitive Transcranial Magnetic Stimulation (nrTMS) of the Dorsolateral Prefrontal and Primary Motor Cortex for the Treatment of Chronic Pain

Medical University of Graz34 enrolled

Overview

This study investigated the effects of navigated repetitive Transcranial Magnetic Stimulation on nociception and quality of life in patients suffering from chronic pain conditions. Two cortical targets (dorsolateral prefrontal cortex/DLPFC and M1 area) were stimulated and compared to Sham stimulation.

From 34 patients, 24 completed the study. The M1-area was stimulated with 10 Hz rTMS while the DLPFC received a 5Hz stimulation. In total, 13 session were administered over a period of 36 weeks with most frequent stimulation in the first 4 weeks of the trial. Results were compared to Sham-TMS over the M1 area at the same schedule than the actual therapy. Outcome parameters included the German Pain Questionnaire (GPQ), the Depression, Anxiety and Stress Scale" (DASS) and quality of life (QoL) with the SF-12 questionnaire.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Chronic Pain

Interventions

navigated repetitive Transcranial StimulationDEVICE

High frequency nrTMS over 13 sessions (1800-2000 pulses per session) over DLPFC and M1 cortical areas.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age between 18 and 80 years * clinical diagnosis of chronic LBP (low back pain) and or neck pain * average resting pain-level \> than 3 in the Numeric Rating Scale (0-10) * no changes in pain medication 4 weeks at baseline * no surgical procedures in the last 2 years Exclusion Criteria: * metallic and electronic implants in the head, neck and chest * medication e.g. tetracyclic antidepressants, antiviral, antipsychotic, opioid doses \> 100mg orally/d * history of frequent headache or tinnitus * alcohol or drug abuse * pregnant patients * breastfeeding patients

Locations (1)

Medical University Graz

Graz, Styria, Austria

Outcomes

Primary Outcomes

Numeric Rating Scale

0-10 0 = no pain, 10 = worst pain

Time frame: 36 weeks

Secondary Outcomes

Self-reported "Depression, Anxiety and Stress Scale" (DASS) questionnaire.

0- 21 for each item, higher scores indicate worse symptoms. Lower scores indicate a better outcome

Time frame: 36 weeks

Data from ClinicalTrials.gov

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