重复经颅磁刺激对急性卒中后中枢性疼痛病人疼痛及生活质量的疗效评价

doi:10.3969/j.issn.1003-9198.2024.12.014

Abstract

Abstract: Objective To evaluate the efficacy of repetitive transcranial magnetic stimulation(rTMS) on pain and the quality of life in the patients with acute central poststroke pain(CPSP). Methods A total of 30 patients aged 60 years and over with acute CPSP were selected and randomly divided into two groups using a random number table. The rTMS group received rTMS intervention treatment (n=15),and the control group received sham rTMS treatment (n=15) for 3 weeks, respectively. At baseline and after 3 weeks of intervention, pain Numeric Rating Scale (NRS), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Brief World Health Organization Quality of Life (WHOQOL-BREF) were evaluated and compared between the two groups. Results There were no significant differences in general condition and the scores of above scales between the two groups at baseline (P>0.05). After 3 weeks of treatment, the score of NRS in the rTMS group was significantly lower than that at baseline and that in the control group (P<0.05); The scores of HAMA and HAMD in the rTMS group were significantly lower than those at baseline (P<0.05), but showing no statistical difference from those in the control group (P>0.05). After 3 weeks of treatment, the sum of the first 28 items of WHOQOL-BREF and the overall score of WHOQOL-BREF showed significant improvement in both groups (P<0.05), especially in the rTMS group(P<0.05). Conclusions rTMS applied to the affected motor cortex can effectively alleviate acute CPSP and improve pain-related emotional disorders and quality of life.

Key words: repetitive transcranial magnetic stimulation, central poststroke pain, emotional disorders, quality of life, aged

CLC Number:

ZHANG Yanwu, WANG Hai, GAO Songnian, SUN Xiaoxing, CHEN Chao, SHEN Yuanyuan, DING Lei. Efficacy of repetitive transcranial magnetic stimulation in relieving pain and quality of life in patients with acute central poststroke pain[J]. Practical Geriatrics, 2024, 38(12): 1250-1254.

References

[1] MURRAY C J, LOPEZ A D.Mortality by cause for eight regions of the world: global burden of disease study[J].Lancet, 1997, 349(9061):1269-1276.
[2] AKYUZ G, KURU P.Systematic review of central post stroke pain: what is happening in the central nervous system?[J].Am J Phys Med Rehabil, 2016, 95(8):618-627.
[3] VUKOJEVIC Z, DOMINOVIC KOVACEVIC A, PERIC S, et al.Frequency and features of the central poststroke pain[J].J Neurol Sci, 2018, 391:100-103.
[4] DUBÉ J A, MERCIER C.Effect of pain and pain expectation on primary motor cortex excitability[J].Clin Neurophysiol, 2011, 122(11):2318-2323.
[5] FLASTER M, MERESH E, RAO M, et al. Central poststroke pain: current diagnosis and treatment[J].Top Stroke Rehabil, 2013, 20(2):116-123.
[6] ATTAL N.Pharmacological treatments of neuropathic pain: the latest recommendations[J].Rev Neurol: Paris, 2019, 175(1/2):46-50.
[7] MOISSET X, BOUHASSIRA D, AVEZ COUTURIER J, et al. Pharmacological and non-pharmacological treatments for neuropathic pain: systematic review and French recommendations[J].Rev Neurol: Paris, 2020, 176(5):325-352.
[8] LEFAUCHEUR J P, ALEMAN A, BAEKEN C, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): an update (2014-2018)[J].Clin Neurophysiol, 2020, 131(2):474-528.
[9] LEFAUCHEUR J P, ANDRÉ-OBADIA N, ANTAL A, et al.Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)[J].Clin Neurophysiol, 2014, 125(11):2150-2206.
[10] KLIT H, FINNERUP N B, JENSEN T S.Central post-stroke pain: clinical characteristics, pathophysiology, and management[J].Lancet Neurol, 2009, 8(9):857-868
[11] GRAY P. Acute neuropathic pain: diagnosis and treatment[J].Curr Opin Anaesthesiol, 2008, 21(5):590-595.
[12] DWORKIN R H, TURK D C, FARRAR J T, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations[J].Pain, 2005, 113(1/2):9-19.
[13] HAMILTON M.The assessment of anxiety states by rating[J].Br J Med Psychol, 1959, 32(1):50-55.
[14] HAMILTON M.A rating scale for depression[J].J Neurol Neurosurg Psychiatry, 1960, 23(1):56-62.
[15] The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties[J].Soc Sci Med, 1998, 46(12):1569-1585.
[16] ATTAL N, AYACHE S S, CIAMPI DE ANDRADE D, et al. Repetitive transcranial magnetic stimulation and transcranial direct-current stimulation in neuropathic pain due to radiculopathy: a randomized sham-controlled comparative study[J].Pain, 2016, 157(6):1224-1231.
[17] KHEDR E M, KOTB H I, MOSTAFA M G, et al. Repetitive transcranial magnetic stimulation in neuropathic pain secondary to malignancy: a randomized clinical trial[J].Eur J Pain, 2015, 19(4):519-527.
[18] HOSOMI K, SUGIYAMA K, NAKAMURA Y, et al. A randomized controlled trial of 5 daily sessions and continuous trial of 4 weekly sessions of repetitive transcranial magnetic stimulation for neuropathic pain[J].Pain, 2020, 161(2):351-360.
[19] KANG B S, SHIN H I, BANG M S. Effect of repetitive transcranial magnetic stimulation over the hand motor cortical area on central pain after spinal cord injury[J].Arch Phys Med Rehabil, 2009, 90(10):1766-1771.
[20] ZHAO C G, SUN W, JU F, et al. Analgesic effects of navigated repetitive transcranial magnetic stimulation in patients with acute central poststroke pain[J].Pain Ther, 2021, 10(2):1085-1100.
[21] KOBAYASHI M, FUJIMAKI T, MIHARA B, et al. Repetitive transcranial magnetic stimulation once a week induces sustainable long-term relief of central poststroke pain[J].Neuromodulation, 2015, 18(4):249-254.
[22] MYLIUS V, BORCKARDT J J, LEFAUCHEUR J P.Noninvasive cortical modulation of experimental pain[J].Pain, 2012, 153(7):1350-1363.
[23] GARCIA-LARREA L, PEYRON R.Motor cortex stimulation for neuropathic pain: from phenomenology to mechanisms[J].Neuroimage, 2007, 37(Suppl 1):S71-S79.
[24] LINDHOLM P, LAMUSUO S, TAIMINEN T, et al. Right secondary somatosensory cortex-a promising novel target for the treatment of drug-resistant neuropathic orofacial pain with repetitive transcranial magnetic stimulation[J].Pain, 2015, 156(7):1276-1283.

Efficacy of repetitive transcranial magnetic stimulation in relieving pain and quality of life in patients with acute central poststroke pain

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Recommended 10

[1]	LI Jiang, QIU Yan, WANG Ting, WANG Dan, YU Yifan, PU Lingli, BU Ling. Correlation between preoperative SII/ALB and clinicopathologic features in elderly patients with lung adenocarcinoma [J]. Practical Geriatrics, 2024, 38(9): 893-896.
[2]	DAI Jing, CUI Yan. Correlation between glycosylated hemoglobin variability and cognitive dysfunction in elderly patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2024, 38(9): 931-935.
[3]	ZHENG Hong, QI Zhenbo, XU Peng, XU Jie, YU Xinyu, ZANG Yanan, ZHANG Zhaoyan. Effects of hypnotics on cognition function and daytime sleepiness in the elderly [J]. Practical Geriatrics, 2024, 38(9): 936-939.
[4]	ZHANG Xingxing, ZHANG Haiyang, HE Xiaojing, LU Xiang. Investigation on the relationship between different physical indexes and the risk of diabetes mellitus in the elderly [J]. Practical Geriatrics, 2024, 38(9): 940-943.
[5]	NI Hongyan, CHEN Yun, ZHANG Qibing, MA Yiming, XIE Chenglan. Effects of electroacupuncture on cognitive function and inflammatory factors in elderly patients undergoing lower limb orthopedic surgery during the perioperative period [J]. Practical Geriatrics, 2024, 38(9): 944-947.
[6]	LI Xiaomin, LI Xiaolin, LI Jie, WU Lei, HAO Ranran. Efficiency influencing factors of transanal double-balloon enteroscopy in elderly patients [J]. Practical Geriatrics, 2024, 38(9): 958-961.
[7]	CAI Huicui, CHEN Yan, WANG Yan, YE Jinjun, ZHU Yuying. Effects of diversified health education model with simple respiratory function exercise on cancer-related fatigue and compliance behavior in elderly patients with lung cancer receiving radiotherapy [J]. Practical Geriatrics, 2024, 38(9): 968-972.
[8]	WANG Xiaojiao, WANG Ning, CUI Hong, YE Tong, WANG Xiaoming. Influence of exercise rehabilitation in elderly patients with mild to moderate chronic heart failure [J]. Practical Geriatrics, 2024, 38(8): 775-778.
[9]	SHEN Chenjun, WANG Xiaoqing, TANG Degang, NING Ping. Correlation between standardized uric acid and renal function in elderly patients with chronic kidney disease aged 90 and over [J]. Practical Geriatrics, 2024, 38(8): 779-782.
[10]	HAO Shijie, ZOU Jianpeng, WEI Chen, LIU Qingjiang. Effect of comprehensive respiratory training on hypokinetic dysarthria in elderly patients with Parkinson’s disease [J]. Practical Geriatrics, 2024, 38(8): 783-787.
[11]	XIANG Chao, LUO Caidong. Analysis of the diagnostic value of T wave change of avL lead for the degree of coronary artery stenosis in elderly patients with coronary heart disease [J]. Practical Geriatrics, 2024, 38(8): 788-791.
[12]	LI Huiying, CAI Lili, ZHU Qiwei. Predictive value of plasma N-terminal pro-brain natriuretic peptide for prognosis in patients aged ≥80 years old with left ventricular hypertrophy [J]. Practical Geriatrics, 2024, 38(8): 797-801.
[13]	WANG Xinping, XIE Baimei, WEI Guo, YE Xiaoli, ZHAO Yayun, TAN Xiaotian. Expression levels and clinical significance of serum S100A9 and sCD163 in elderly patients with idiopathic interstitial pneumonia [J]. Practical Geriatrics, 2024, 38(8): 802-807.
[14]	LIU Meijuan, WANG Ning, WANG Dong, LU Fangzhou, LIU Juan. Effect of low-dose lidocaine combined with propofol on motor evoked potential in elderly patients undergoing intracranial tumor resection [J]. Practical Geriatrics, 2024, 38(8): 808-811.
[15]	LI Jingbing, WANG Huijun, WANG Shaoying, ZHAO Can, WANG Lidi, CAO Yujiao. Impacts of pentoxifylline combined with lipoic acid intervention on physical function and quality of life in elderly patients with frailty syndrome [J]. Practical Geriatrics, 2024, 38(8): 812-815.