Clinical study of high-frequency repetitive transcranial magnetic stimulation regularly and intermittently in the treatment of central pain after thalamic infarction

doi:10.3877/cma.j.issn.2095-123X.2022.05.003

Abstract

Abstract:

Objective

To explore the clinical efficacy and mechanism of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in the treatment of central pain after thalamic infarction.

Methods

Sixty-four patients with central pain after thalamic infarction were selected from Neurology Department of Anqing Municipal Hospital from April 2020 to December 2021, and were divided into hrTMS group and control group by single-blind randomized method, with 32 cases in each group. Two groups were given ibuprofen sustained-release capsules 0.4 g orally bid during treatment. The hrTMS group received hrTMS treatment, and the control group received pseudo-coil treatment without magnetic pulse emission. Visual analog scale (VAS) scores, motor evoked potential (MEP) latency and total response rate were compared between the two groups.

Results

VAS scores in hrTMS group decreased gradually before treatment and at 2, 4 and 8 weeks after treatment, with statistical significance (P<0.05). Comparison of VAS scores in the control group before treatment, 2 weeks after treatment and 4 weeks after treatment showed statistically significant difference (P<0.05), but there was no statistically significant difference between 4 weeks after treatment and 8 weeks after treatment (P>0.05). There was no significant difference in VAS scores between 2 groups before treatment and 2 weeks after treatment (P>0.05). VAS scores at 4 and 8 weeks after treatment were statistically significant (P<0.05). After 8 weeks of treatment, the latency of MEP in the hrTMS group was significantly shorter than that before treatment, and the latency of MEP in the control group was significantly shorter, the difference was statistically significant (P<0.05). After 8 weeks of treatment, the total effective rate of hrTMS group (71.88%) was significantly higher than that of control group (15.63%), and the difference was statistically significant (P<0.05).

Conclusion

Regular intermittent treatment with hrTMS can relieve the pain degree of the patients with central pain after thalamic infarction and the effect is significant. The possible mechanism of action is related to the improvement of cerebral cortical excitability in the patients with cerebral infarction.

Key words: Thalamic infarction, Central pain, Transcranial magnetic stimulation, Motor evoked potentials

Wei Jiang, Liangjin Yuan, Xiangyang Tang, Doufeng Zhang, Shaomin Wang. Clinical study of high-frequency repetitive transcranial magnetic stimulation regularly and intermittently in the treatment of central pain after thalamic infarction[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(05): 269-273.

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References 21

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组别	例数	年龄（岁，Mean±SD）	性别（男/女）	受教育程度（年，Mean±SD）	发病病程（d，Mean±SD）	VAS评分（分，Mean±SD）
hrTMS组	32	61.56±6.36	19/13	12.13±2.97	33.25±7.66	7.06±0.91
对照组	32	60.13±7.87	17/15	11.59±2.78	32.81±6.29	6.84±0.85
t/χ²值		0.804	0.254	0.739	0.250	0.993
P值		0.425	0.614	0.463	0.804	0.324

组别	例数	年龄（岁，Mean±SD）	性别（男/女）	受教育程度（年，Mean±SD）	发病病程（d，Mean±SD）	VAS评分（分，Mean±SD）
hrTMS组	32	61.56±6.36	19/13	12.13±2.97	33.25±7.66	7.06±0.91
对照组	32	60.13±7.87	17/15	11.59±2.78	32.81±6.29	6.84±0.85
t/χ²值		0.804	0.254	0.739	0.250	0.993
P值		0.425	0.614	0.463	0.804	0.324

时间	hrTMS组（n=32）	对照组（n=32）	t值	P值
治疗前	7.06±0.91	6.84±0.85	0.993	0.324
治疗2周后	6.16±1.05^a	6.56±0.91^a	-1.885	0.064
治疗4周后	5.34±0.90^ab	6.40±0.87^ab	-4.784	<0.001
治疗8周后	4.25±1.19^abc	6.25±0.95^ab	-7.424	<0.001
F值	91.420	13.786
P值	<0.001	<0.001

时间	hrTMS组（n=32）	对照组（n=32）	t值	P值
治疗前	7.06±0.91	6.84±0.85	0.993	0.324
治疗2周后	6.16±1.05^a	6.56±0.91^a	-1.885	0.064
治疗4周后	5.34±0.90^ab	6.40±0.87^ab	-4.784	<0.001
治疗8周后	4.25±1.19^abc	6.25±0.95^ab	-7.424	<0.001
F值	91.420	13.786
P值	<0.001	<0.001

组别	例数	显效	有效	无效	总有效率[例（%）]
hrTMS组	32	2	21	9	23（71.88）
对照组	32	0	5	27	5（15.63）
Z/χ²值			-4.527		20.570
P值			<0.001		<0.001

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