TY - JOUR
T1 - Left dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation reduces the development of long-term muscle pain
AU - Seminowicz, David A.
AU - Martino, Enrico de
AU - Schabrun, Siobhan M.
AU - Graven-Nielsen, Thomas
PY - 2018
Y1 - 2018
N2 - The left dorsolateral prefrontal cortex (DLPFC) is involved in the experience and modulation of pain, and may be an important node linking pain and cognition. Repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC can reduce chronic and experimental pain. However, whether left DLPFC rTMS can influence the development of chronic pain is unknown. Using repeated intramuscular injection of nerve growth factor (NGF) to induce the development of sustained muscle pain (lasting weeks), thirty healthy individuals were randomized to receive 5 consecutive daily treatments of active or sham left DLPFC rTMS, starting before the first NGF injection on day 0. Muscle soreness and pain severity were collected daily for 14 days and disability on every alternate day. Before the first and one day after the last rTMS session, anxiety, depression, affect, pain catastrophizing and cognitive performance on the attention network test were assessed. Left DLPFC rTMS treatment compared to sham was associated with reduced muscle soreness, pain intensity, and painful area (p<0.05), and a similar trend was observed for disability. These effects were most evident during the days rTMS was applied lasting up to three days following intervention. Depression, anxiety, pain catastrophizing, and affect were unchanged. There was a trend toward improved cognitive function with rTMS compared to sham (p=0.057). These data indicate that repeated left DLPFC rTMS reduces the pain severity in a model of prolonged muscle pain. The findings may have implications for the development of sustained pain in clinical populations.
AB - The left dorsolateral prefrontal cortex (DLPFC) is involved in the experience and modulation of pain, and may be an important node linking pain and cognition. Repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC can reduce chronic and experimental pain. However, whether left DLPFC rTMS can influence the development of chronic pain is unknown. Using repeated intramuscular injection of nerve growth factor (NGF) to induce the development of sustained muscle pain (lasting weeks), thirty healthy individuals were randomized to receive 5 consecutive daily treatments of active or sham left DLPFC rTMS, starting before the first NGF injection on day 0. Muscle soreness and pain severity were collected daily for 14 days and disability on every alternate day. Before the first and one day after the last rTMS session, anxiety, depression, affect, pain catastrophizing and cognitive performance on the attention network test were assessed. Left DLPFC rTMS treatment compared to sham was associated with reduced muscle soreness, pain intensity, and painful area (p<0.05), and a similar trend was observed for disability. These effects were most evident during the days rTMS was applied lasting up to three days following intervention. Depression, anxiety, pain catastrophizing, and affect were unchanged. There was a trend toward improved cognitive function with rTMS compared to sham (p=0.057). These data indicate that repeated left DLPFC rTMS reduces the pain severity in a model of prolonged muscle pain. The findings may have implications for the development of sustained pain in clinical populations.
KW - brain
KW - magnetic brain stimulation
KW - muscles
KW - nerve growth factor
KW - pain
UR - https://handle.westernsydney.edu.au:8081/1959.7/uws:47797
U2 - 10.1097/j.pain.0000000000001350
DO - 10.1097/j.pain.0000000000001350
M3 - Article
SN - 1872-6623
SN - 0304-3959
VL - 159
SP - 2486
EP - 2492
JO - Pain
JF - Pain
IS - 12
ER -