Effect and reliability of Transcranial Magnetic Stimulation on neuropathic pain, depressive symptoms in stroke patients: Preliminary Study

Abstract

Objective: In this paper, we aimed to evaluate the effect of repetitive Transcranial Magnetic Stimulation (rTMS) on central pain in patients with stroke. Material and Methods: Ten patients who had a stroke history were included in this preliminary study. Patients with middle cerebral artery lesion, first-time stroke, subacute or chronic lesion and no other neurological involvement were included. Patients were examined before and after the first month of treatment with repetitive Transcranial Magnetic Stimulation (rTMS). Visual Analog Scale (VAS) was used for pain scale measurement; Leeds Assessment of Neuropathic Symptoms and Signs Scale (LANSS) and Douleur Neuropathique en 4 Questions (DN4) were used for neuropathic pain level and Beck Depression Inventory (BDI) for depressive mood. All patients received the current treatments and appropriate neurorehabilitation as recommended for the treatment of ischemic stroke Results: This prospective study included a total of 10 post-stroke patients (mean age 58.2 ± 16.1 years; range 29 to 75, 8 male; 2 female) with neuropathic pain. The mean values of VAS, LANSS, DN4 and BDI scales were significantly decreased after rTMS treatment in all patients. Conclusion: We discussed the preliminary results of the efficacy and safety of rTMS in the treatment of uncontrolled neuropathic pain. We consider that, rTMS may have significant effect on relief of chronic pain. These clinical parameters can be utilized for the further study of rTMS application in pain control.