Analgesic Effect of Accelerated Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain

Peripheral neuropathy is a frequent condition, commonly associated with pain, which is often drug resistant. Repetitive Transcranial Magnetic Stimulation (rTMS) is a noninvasive method of modulation of brain plasticity. In this method, series of magnetic stimuli are delivered to the cerebral cortex, where they turn to electric current and depolarize repetitively the targeted neurons. If the stimulation is repeated during subsequent days it is capable to modify the activity of targeted cortical area for weeks or even months and by this way to achieve therapeutic effect. rTMS is most commonly used to treat drug-resistant depression but a number of other psychiatric and neurologic conditions is increasingly being regarded as therapeutic indication for rTMS. In patients suffering from neuropathic pain rTMS is delivered with high frequency, over primary motor areas (PMA). Stimulation of PMA should result in modulation of thalamic activity, achieved by antidromic excitation of thalamocortical connections. rTMS is usually performed once a day and the whole therapy of neuropathic pain lasts one week. In a number of recent clinical trials including patients with depression and some other disorders, rTMS was delivered several times a day, which reduced the time of the whole therapy. This approach was termed an accelerated rTMS. The purpose of this study is to investigate feasibility of accelerated rTMS in treatment of neuropathic pain.

• Numeric Pain Severity Scale after rTMS [Срок оценки: Before rTMS, up to one day after finishing rTMS.]
• Numeric Pain Severity Scale First Follow-up [Срок оценки: Before rTMS, two weeks after finishing rTMS.]
• Numeric Pain Severity Scale Second Follow-up [Срок оценки: Before rTMS, four weeks after finishing rTMS.]
• Neuropathic Pain Symptoms Inventory after rTMS [Срок оценки: Before rTMS, up to one day after finishing rTMS.]
• Neuropathic Pain Symptoms Inventory First Follow-up [Срок оценки: Before rTMS, two weeks after finishing rTMS.]
• Neuropathic Pain Symptoms Inventory Second Follow-up [Срок оценки: Before rTMS, four weeks after finishing rTMS.]
• Athens Insomnia Scale after rTMS [Срок оценки: Before rTMS, up to one day after finishing rTMS.]
• Athens Insomnia Scale First Follow-up [Срок оценки: Before rTMS, two weeks after finishing rTMS.]
• Athens Insomnia Scale Second Follow-up [Срок оценки: Before rTMS, four weeks after finishing rTMS.]
• Bilateral Dynamometric Assessment of the strength of the foot extension after rTMS [Срок оценки: Before rTMS, up to one day after finishing rTMS.]
• Bilateral Dynamometric Assessment of the strength of the foot extension First Follow-up [Срок оценки: Before rTMS, two weeks after finishing rTMS.]
• Bilateral Dynamometric Assessment of the strength of the foot extension Second Follow-up [Срок оценки: Before rTMS, four weeks after finishing rTMS.]