Observation of repeated transcranial magnetic stimulation combined with gabapentin in the treatment of neuropathic pain after spinal cord injury

doi:10.3877/cma.j.issn.2095-123X.2019.06.006

Abstract

Abstract:

Objective

To investigate the clinical effect of repetitive transcranial magnetic stimulation (rTMS) combined with gabapentin in the treatment of neuropathic pain (NP) after spinal cord injury (SCI).

Methods

Sixty patients with NP after SCI, admitted to Department of Neurorehabilitation of Suzhou Ruisheng Rehabilitation Hospital from January 2017 to December 2018, were enrolled. They were randomly divided into the experimental group and the control group by each group 30 cases. Both groups were given gabapentin. The experimental group was treated with 10 Hz of rTMS in the M1 area. The control group gave the sham therapy with same pattern and the same volume stimuli in the M1 area. Pain was assessed by visual analogue scale (VAS) before and after treatment at 1, 2, 4, and 6 weeks The Hamilton depression scale (HAMD) and anxiety scale (HAMA) were used before and after treatment and observed the maximum dose of gabapentin, side effects and side effects of TMS.

Results

At the first week after treatment, the VAS scores of the two groups were not significantly improved (P>0.05), and there was no significant difference between 2 groups (P>0.05). After 2, 4, and 6 weeks of treatment, the VAS scores of the experimental group were lower than those of the control group, especially at the 6^th week (P<0.05). After 6 weeks of treatment, the HAMD score and the HAMA score were better in the experimental group than in the control group (P<0.05).

Conclusion

rTMS combined with gabapentin has a good clinical effect in treatment of SCI. It can effectively control pain, improve depression, anxiety and sleep disorders caused by pain in SCI patients. The safety and reliability of treatment are good.

Key words: Repetitive transcranial magnetic stimulation, Gabapentin, Spinal cord injury, Neuropathic pain

Yanping Guo, Ben Huang, Xuemei Zhou. Observation of repeated transcranial magnetic stimulation combined with gabapentin in the treatment of neuropathic pain after spinal cord injury[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2019, 09(06): 345-349.

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References 26

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组别	例数	性别（男/女）	年龄（岁）	病程（月）
对照组	30	21/9	36.01±9.71	4.97±1.34
观察组	30	22/8	36.44±12.84	4.84±1.63
χ²/t值	?	0.353	0.281	0.684
P值	?	0.503	0.512	0.596

组别	例数	性别（男/女）	年龄（岁）	病程（月）
对照组	30	21/9	36.01±9.71	4.97±1.34
观察组	30	22/8	36.44±12.84	4.84±1.63
χ²/t值	?	0.353	0.281	0.684
P值	?	0.503	0.512	0.596

组别	例数	治疗前	治疗后
组别	例数	治疗前	第1周	第2周	第4周	第6周
对照组	30	7.63±1.50	6.71±0.78^a	6.05±0.67	5.33±0.58	4.42±0.98^a
观察组	30	7.86±0.85	6.52±0.68^a	5.29±0.78	4.24±0.62	2.38±0.92^a
χ²/t值	?	0.324	0.678	2.804	7.640	8.961
P值	?	0.747	0.501	0.007	0.002	0.001

组别	例数	治疗前	治疗后
组别	例数	治疗前	第1周	第2周	第4周	第6周
对照组	30	7.63±1.50	6.71±0.78^a	6.05±0.67	5.33±0.58	4.42±0.98^a
观察组	30	7.86±0.85	6.52±0.68^a	5.29±0.78	4.24±0.62	2.38±0.92^a
χ²/t值	?	0.324	0.678	2.804	7.640	8.961
P值	?	0.747	0.501	0.007	0.002	0.001

评分	组别	例数	治疗前	治疗后	t值	P值
HAMD	对照组	30	15.21±6.10	12.57±5.86	3.878	<0.001
	观察组	30	15.17±6.03	10.11±5.31	3.917	<0.001
	t值	?	0.223	4.377	?	?
	P值	?	0.824	0.001	?	?
HAMA	对照组	30	18.20±4.60	15.70±5.80	6.360	<0.001
	观察组	30	18.61±5.01	12.17±5.31	5.882	<0.001
	t值	?	1.165	4.853	?	?
	P值	?	0.549	0.001	?	?

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