Pressure Pain Thresholds Increase after Preconditioning 1 Hz Repetitive Transcranial Magnetic Stimulation with Transcranial Direct Current StimulationReportar como inadecuado




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Background

The primary motor cortex M1 is an effective target of non-invasive cortical stimulation NICS for pain threshold modulation. It has been suggested that the initial level of cortical excitability of M1 plays a key role in the plastic effects of NICS.

Objective

Here we investigate whether transcranial direct current stimulation tDCS primed 1 Hz repetitive transcranial magnetic stimulation rTMS modulates experimental pressure pain thresholds and if this is related to observed alterations in cortical excitability.

Method

15 healthy, male participants received 10 min 1 mA anodal, cathodal and sham tDCS to the left M1 before 15 min 1 Hz rTMS in separate sessions over a period of 3 weeks. Motor cortical excitability was recorded at baseline, post-tDCS priming and post-rTMS through recording motor evoked potentials MEPs from right FDI muscle. Pressure pain thresholds were determined by quantitative sensory testing QST through a computerized algometer, on the palmar thenar of the right hand pre- and post-stimulation.

Results

Cathodal tDCS-primed 1 Hz-rTMS was found to reverse the expected suppressive effect of 1 Hz rTMS on cortical excitability; leading to an overall increase in activity p<0.001 with a parallel increase in pressure pain thresholds p<0.01. In contrast, anodal tDCS-primed 1 Hz-rTMS resulted in a corresponding decrease in cortical excitability p<0.05, with no significant effect on pressure pain.

Conclusion

This study demonstrates that priming the M1 before stimulation of 1 Hz-rTMS modulates experimental pressure pain thresholds in a safe and controlled manner, producing a form of analgesia.



Autor: Tonya M. Moloney , Alice G. Witney

Fuente: http://plos.srce.hr/



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