Repetitive Transcranial Magnetic Stimulation for Phantom Limb Pain: Probably Effective but Understudied

2017 ◽  
Vol 20 (1) ◽  
pp. 88-89 ◽  
Author(s):  
Arman Taheri ◽  
Mahbod Lajevardi ◽  
Saghar Arab ◽  
Abolfazl Firouzian ◽  
Hassan Sharifi
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain

scholarly journals Phantom Limb Pain: Low Frequency Repetitive Transcranial Magnetic Stimulation in Unaffected Hemisphere

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Andrea Di Rollo ◽  
Stefano Pallanti
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Cortex ◽  
Magnetic Stimulation ◽  
Pain Treatment ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Limb Pain

Phantom limb pain is very common after limb amputation and is often difficult to treat. The motor cortex stimulation is a valid treatment for deafferentation pain that does not respond to conventional pain treatment, with relief for 50% to 70% of patients. This treatment is invasive as it uses implanted epidural electrodes. Cortical stimulation can be performed noninvasively by repetitive transcranial magnetic stimulation (rTMS). The stimulation of the hemisphere that isn't involved in phantom limb (unaffected hemisphere), remains unexplored. We report a case of phantom limb pain treated with 1 Hz rTMS stimulation over motor cortex in unaffected hemisphere. This stimulation produces a relevant clinical improvement of phantom limb pain; however, further studies are necessary to determine the efficacy of the method and the stimulation parameters.

scholarly journals Recent advances in understanding and managing phantom limb pain

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1167 ◽  
Author(s):  
Andrea Aternali ◽  
Joel Katz
Keyword(s):  
Repetitive Transcranial Magnetic Stimulation ◽  
Growth Mixture Modeling ◽  
Phantom Limb Pain ◽  
Small Sample ◽  
Phantom Limb ◽  
Mirror Therapy ◽  
Limb Pain ◽  
Pain Mechanisms ◽  
Recent Advances ◽  
Analytical Approaches

Post-amputation phantom limb pain (PLP) is highly prevalent and very difficult to treat. The high-prevalence, high-pain intensity levels, and decreased quality of life associated with PLP compel us to explore novel avenues to prevent, manage, and reverse this chronic pain condition. This narrative review focuses on recent advances in the treatment of PLP and reviews evidence of mechanism-based treatments from randomized controlled trials published over the past 5 years. We review recent evidence for the efficacy of targeted muscle reinnervation, repetitive transcranial magnetic stimulation, imaginal phantom limb exercises, mirror therapy, virtual and augmented reality, and eye movement desensitization and reprocessing therapy. The results indicate that not one of the above treatments is consistently better than a control condition. The challenge remains that there is little level 1 evidence of efficacy for PLP treatments and most treatment trials are underpowered (small sample sizes). The lack of efficacy likely speaks to the multiple mechanisms that contribute to PLP both between and within individuals who have sustained an amputation. Research approaches are called for to classify patients according to shared factors and evaluate treatment efficacy within classes. Subgroup analyses examining sex effects are recommended given the clear differences between males and females in pain mechanisms and outcomes. Use of novel data analytical approaches such as growth mixture modeling for multivariate latent classes may help to identify sub-clusters of patients with common outcome trajectories over time.

Sign in / Sign up

Export Citation Format

Share Document