Modulation of pain perception by transcranial magnetic stimulation of left prefrontal cortex

Filippo Brighina, Marina De Tommaso, Francesca Giglia, Simona Scalia, Giuseppe Cosentino, Angela Puma, Maristella Panetta, Giuseppe Giglia, Brigida Fierro, Filippo Brighina, Marina De Tommaso, Francesca Giglia, Simona Scalia, Giuseppe Cosentino, Angela Puma, Maristella Panetta, Giuseppe Giglia, Brigida Fierro

Abstract

Evidence by functional imaging studies suggests the role of left dorsolateral prefrontal cortex (DLPFC) in the inhibitory control of nociceptive transmission system. Repetitive transcranial magnetic stimulation (rTMS) is able to modulate pain response to capsaicin. In the present study, we evaluated the effect of DLPFC activation (through rTMS) on nociceptive control in a model of capsaicin-induced pain. The study was performed on healthy subjects that underwent capsaicin application on right or left hand. Subjects judged the pain induced by capsaicin through a 0-100 VAS scale before and after 5 Hz rTMS over left and right DLPFC at 10 or 20 min after capsaicin application in two separate groups (8 subjects each). Left DLPFC-rTMS delivered either at 10 and 20 min after capsaicin application significantly decreased spontaneous pain in both hands. Right DLPFC rTMS showed no significant effect on pain measures. According to these results, stimulation of left DLPFC seems able to exert a bilateral control on pain system, supporting the critical antinociceptive role of such area. This could open new perspectives to non-invasive brain stimulation protocols of alternative target area for pain treatment.

© The Author(s) 2011. This article is published with open access at Springerlink.com

Figures

Fig. 1
Fig. 1
Site of capsaicin application and flow chart of the experiment: times for pain measurements and rTMS delivering (10 and 20 min after capsaicin application)
Fig. 2
Fig. 2
Effects of left and right DLPFC rTMS (delivered at 10 min after capsaicin application) on pain: changes in VAS values (mean ± SE) across different times [baseline (0) to 60 min] in conditions without and with rTMS with capsaicin over the right (a) and left hand (b); asterisk indicates significant differences (p < 0.05) in L-DLPFC rTMS with respect to analog time points of the other conditions
Fig. 3
Fig. 3
Effects of left and right DLPFC rTMS (delivered at 20 min after capsaicin application) on pain: changes in VAS values (mean ± SE) across different times [baseline (0) to 60 min] in conditions without and with rTMS with capsaicin over the right (a) and left hand (b); asterisk indicates significant differences (p < 0.05) in L-DLPFC rTMS with respect to analog time points of the other conditions

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