Department of Rehabilitation Medicine, Eulji University Hospital, Daejeon, Republic of Korea.
Department of Rehabilitation Medicine, Eulji University School of Medicine, Daejeon, Republic of Korea.
NeuroRehabilitation. 2020;46(1):127-134. doi: 10.3233/NRE-192958.
Repetitive transcranial magnetic stimulation (rTMS) is one of the effective treatments for neuropathic pain. Little is known about the effects of multi-session theta burst stimulation, one of the new paradigms of rTMS.
The aim of this study was to investigate the effects of multi-session intermittent theta burst stimulation (iTBS) on central neuropathic pain, using evaluation tools specific to neuropathic pain.
Patients with central neuropathic pain diagnosed using Neuropathic Pain Special Interest Group guidelines were recruited. Thirty patients were randomly assigned to either a real or sham iTBS group. Each patient underwent 5 sessions of iTBS; before and after completion of the 5 sessions, participants were evaluated using the self-completed Leeds assessment of neuropathic symptoms and signs (S-LANSS), the numeric rating scale (NRS), the neuropathic pain symptom inventory (NPSI), and the neuropathic pain scale (NPS).
S-LANSS, NRS, NPSI, and 3 of 4 NPS combination scores decreased significantly in the real iTBS group but not in the sham iTBS group. No adverse effects were reported during or after iTBS sessions.
Multi-session iTBS was associated with a significant decrease in neuropathic pain, indicating its effectiveness as a treatment for patients with central neuropathic pain.
重复经颅磁刺激（rTMS）是治疗神经性疼痛的有效方法之一。关于新型 rTMS 模式之一的多疗程θ爆发刺激（iTBS）的影响，人们知之甚少。
本研究旨在使用专门针对神经性疼痛的评估工具，探讨多疗程间歇性θ爆发刺激（iTBS）对中枢神经性疼痛的影响。
根据神经性疼痛特殊兴趣组指南诊断为中枢神经性疼痛的患者被纳入研究。30 名患者被随机分配到真实 iTBS 组或假刺激 iTBS 组。每位患者接受 5 次 iTBS 治疗；在完成 5 次疗程前后，使用自我评估的 Leeds 神经性疼痛症状和体征评估量表（S-LANSS）、数字评分量表（NRS）、神经性疼痛症状量表（NPSI）和神经性疼痛量表（NPS）对参与者进行评估。
真实 iTBS 组的 S-LANSS、NRS、NPSI 和 4 个 NPS 组合评分中的 3 项显著降低，但假刺激 iTBS 组无此变化。在 iTBS 治疗过程中和治疗后均未报告不良反应。
多疗程 iTBS 与神经性疼痛的显著减轻相关，表明其对中枢神经性疼痛患者的治疗有效。
