دورية أكاديمية
Posterior insula repetitive transcranial magnetic stimulation for chronic pain in patients with Parkinson disease - pain type matters: A double-blinded randomized sham-controlled trial.
العنوان: | Posterior insula repetitive transcranial magnetic stimulation for chronic pain in patients with Parkinson disease - pain type matters: A double-blinded randomized sham-controlled trial. |
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المؤلفون: | Barboza VR; Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil., Kubota GT; Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil., da Silva VA; Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil., Barbosa LM; Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil., Arnaut D; Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil., Rodrigues ALL; Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil., Galhardoni R; Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil., Barbosa ER; Movement Disorders Group, Department of Neurology, University of São Paulo., Av. Dr. Enéas Carvalho de Aguiar, 255 - Cerqueira Cesar, Sao Paulo, Sao Paulo 05403-000, Brazil., Brunoni AR; Laboratory of Neuroscience and National Institute of Biomarkers in Psychiatry, Department and Institute of Psychiatry, Center for Clinical and Epidemiological Research & Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785 - Cerqueira Cesar, Sao Paulo, Sao Paulo 05403-903, Brazil., Teixeira MJ; Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil; Movement Disorders Group, Department of Neurology, University of São Paulo., Av. Dr. Enéas Carvalho de Aguiar, 255 - Cerqueira Cesar, Sao Paulo, Sao Paulo 05403-000, Brazil., Cury RG; Movement Disorders Group, Department of Neurology, University of São Paulo., Av. Dr. Enéas Carvalho de Aguiar, 255 - Cerqueira Cesar, Sao Paulo, Sao Paulo 05403-000, Brazil., de Andrade DC; Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil; Center for Neuroplasticity and Pain, Department of Health Sciences and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark. Electronic address: dca@hst.aau.dk. |
المصدر: | Neurophysiologie clinique = Clinical neurophysiology [Neurophysiol Clin] 2024 Jul 17; Vol. 54 (5), pp. 102994. Date of Electronic Publication: 2024 Jul 17. |
Publication Model: | Ahead of Print |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Country of Publication: France NLM ID: 8804532 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1769-7131 (Electronic) Linking ISSN: 09877053 NLM ISO Abbreviation: Neurophysiol Clin Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Paris : Elsevier Original Publication: Amsterdam ; New York : Elsevier, c1988- |
مستخلص: | Objectives: Altered somatosensory processing in the posterior insula may play a role in chronic pain development and contribute to Parkinson disease (PD)-related pain. Posterior-superior insula (PSI) repetitive transcranial magnetic stimulation (rTMS) has been demonstrated to have analgesic effects among patients with some chronic pain conditions. This study aimed at assessing the efficacy of PSI-rTMS for treating PD-related pain. Methods: This was a double-blinded, randomized, sham-controlled, parallel-arm trial (NCT03504748). People with PD (PwP)-related chronic pain underwent five daily PSI-rTMS sessions for a week, followed by once weekly maintenance stimulations for seven weeks. rTMS was delivered at 10 Hz and 80% of the resting motor threshold. The primary outcome was a ≥ 30% pain intensity reduction at 8 weeks compared to baseline. Functionality, mood, cognitive, motor status, and somatosensory thresholds were also assessed. Results: Twenty-five patients were enrolled. Mean age was 55.2 ± 9.5 years-old, and 56% were female. Nociceptive pain accounted for 60%, and neuropathic and nociplastic for 20% each. No significant difference was found for 30% pain reduction response rates between active (42.7%) and sham groups (14.6%, p = 0.26). Secondary clinical outcomes and sensory thresholds also did not differ significantly. In a post hoc analysis, PwP with nociceptive pain sub-type experienced more pain relief after active (85.7%) compared to sham PSI-rTMS (25%, p = 0.032). Conclusion: Our preliminary results suggest that different types of PD-related pain may respond differently to treatment, and therefore people with PD may benefit from having PD-related pain well characterized in research trials and in clinical practice. Competing Interests: Declaration of competing interest None. (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.) |
فهرسة مساهمة: | Keywords: Chronic pain; Insula; Non-motor symptoms, nociceptive pain; Parkinson disease; Transcranial magnetic stimulation |
تواريخ الأحداث: | Date Created: 20240718 Latest Revision: 20240718 |
رمز التحديث: | 20240719 |
DOI: | 10.1016/j.neucli.2024.102994 |
PMID: | 39024845 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1769-7131 |
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DOI: | 10.1016/j.neucli.2024.102994 |