Non-invasive insular stimulation for peripheral neuropathic pain: Influence of target or symptom?
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Citações na Scopus
5
Tipo de produção
article
Data de publicação
2022
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
Autores
THIBES, Raissa Benocci
SATO, Joao
TANAKA, Harki
Citação
NEUROPHYSIOLOGIE CLINIQUE-CLINICAL NEUROPHYSIOLOGY, v.52, n.2, p.109-116, 2022
Resumo
Objectives: The posterior-superior insula (PSI) has been shown to be a safe and potentially effective target for neuromodulation in peripheral neuropathic pain (PNP) in humans and animal models. However, it remains unknown whether there is a measurable responder profile to PSI stimulation. Two factors were hypothesized to influence the response of repetitive transcranial magnetic stimulation (rTMS) of the PSI: differences in rTMS target (discrete subregions of the PSI) or PNP phenotype. Methods: This is a secondary analysis from a randomized, double-blind, sham-controlled, crossover trial assessing PSI-rTMS in PNP (N = 31, 5 days rTMS) (10.1016/j.neucli.2021.06.003). Active PSI-rTMS true responders (>50% pain reduction from baseline after active but not after sham series of treatment) were compared with not true responders, to determine whether they differed with respect to 1) rTMS neuro-navigational target coordinates, and/or 2) specific neuropathic pain symptom inventory (NPSI) clusters (pinpointed pain, evoked pain, and deep pain) at baseline. Results: Mean rTMS target coordinates did not differ between true (n = 45.1%) and not true responders (p = 0.436 for X, p = 0.120 for Y, and p = 0.116 for Z). The Euclidian distance between true and not true responders was 4.04 mm. When comparing differences in responders between NPSI clusters, no participant within the evoked pain cluster was a true responder (p = 0.024). Conclusion: Response to PSI-rTMS may depend on pain cluster subtype rather than on differences in targeting within the PSI.
Palavras-chave
Insula, Neuronavigation, Neuropathic pain, Peripheral neuropathy, Symptom profile, Transcranial magnetic stimulation
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