Skip to Main content Skip to Navigation
New interface
Journal articles

Better Fields or Currents? A Head-to-Head Comparison of Transcranial Magnetic (rTMS) Versus Direct Current Stimulation (tDCS) for Neuropathic Pain

Abstract : While high-frequency transcranial magnetic stimulation (HF-rTMS) is now included in the armamentarium to treat chronic neuropathic pain (NP), direct-current anodal stimulation (a-tDCS) to the same cortical targets may represent a valuable alternative in terms of feasibility and cost. Here we performed a head-to-head, randomized, single-blinded, cross-over comparison of HF-rTMS versus a-tDCS over the motor cortex in 56 patients with drug-resistant NP, who received 5 daily sessions of each procedure, with a washout of at least 4 weeks. Daily scores of pain, sleep, and fatigue were obtained during 5 consecutive weeks, and functional magnetic resonance imaging (fMRI) to a motor task was performed in a subgroup of 31 patients. The percentage of responders, defined by a reduction in pain scores of > 2 SDs from pre-stimulus levels, was similar to both techniques (42.0% vs. 42.3%), while the magnitude of "best pain relief" was significantly skewed towards rTMS. Mean pain ratings in responders decreased by 32.6% (rTMS) and 29.6% (tDCS), with half of them being sensitive to only one technique. Movement-related fMRI showed significant activations in motor and premotor areas, which did not change after 5 days of stimulation, and did not discriminate responders from non-responders. Both HF-rTMS and a-tDCS showed efficacy at 1 month in drug-resistant NP, with magnitude of relief slightly favoring rTMS. Since a significant proportion of patients responded to one procedure only, both modalities should be tested before declaring a patient as unresponsive.
Complete list of metadata

https://hal-cnrs.archives-ouvertes.fr/hal-03823807
Contributor : Isabelle Faillenot Connect in order to contact the contributor
Submitted on : Friday, October 21, 2022 - 11:01:38 AM
Last modification on : Wednesday, October 26, 2022 - 3:08:26 AM

File

Andre-Obadia2022_rTMS-versus-t...
Files produced by the author(s)

Identifiers

Citation

Nathalie André-Obadia, Hasan Hodaj, Enkelejda Hodaj, Emile Simon, Chantal Delon-Martin, et al.. Better Fields or Currents? A Head-to-Head Comparison of Transcranial Magnetic (rTMS) Versus Direct Current Stimulation (tDCS) for Neuropathic Pain. Neurotherapeutics, 2022, ⟨10.1007/s13311-022-01303-x⟩. ⟨hal-03823807⟩

Share

Metrics

Record views

0

Files downloads

0