New Developments in Non-invasive Brain Stimulation in Chronic Pain

doi:10.1007/s40141-020-00260-w

. 2020 Sep;8(3):280-292.

doi: 10.1007/s40141-020-00260-w. Epub 2020 May 11.

New Developments in Non-invasive Brain Stimulation in Chronic Pain

Timothy J Meeker^{1

2}, Rithvic Jupudi¹, Frederik A Lenz¹, Joel D Greenspan²

Affiliations

¹ Dept. of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
² Dept. of Neural and Pain Sciences, School of Dentistry, and Center to Advance Chronic Pain Research, Univ. of Maryland Baltimore, Baltimore, MD, USA.

PMID: 33473332
PMCID: PMC7814313
DOI: 10.1007/s40141-020-00260-w

New Developments in Non-invasive Brain Stimulation in Chronic Pain

Timothy J Meeker et al. Curr Phys Med Rehabil Rep. 2020 Sep.

. 2020 Sep;8(3):280-292.

doi: 10.1007/s40141-020-00260-w. Epub 2020 May 11.

Authors

Timothy J Meeker^{1

2}, Rithvic Jupudi¹, Frederik A Lenz¹, Joel D Greenspan²

Affiliations

¹ Dept. of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
² Dept. of Neural and Pain Sciences, School of Dentistry, and Center to Advance Chronic Pain Research, Univ. of Maryland Baltimore, Baltimore, MD, USA.

PMID: 33473332
PMCID: PMC7814313
DOI: 10.1007/s40141-020-00260-w

Abstract

Purpose of review: The goal of this review is to present a summary of the recent literature of a non-invasive brain stimulation (NIBS) to alleviate pain in people with chronic pain syndromes. This article reviews the current evidence for the use of transcranial direct current (tDCS) and repetitive transcranial magnetic stimulation (rTMS) to improve outcomes in chronic pain. Finally, we introduce the reader to novel stimulation methods that may improve therapeutic outcomes in chronic pain.

Recent findings: While tDCS is approved for treatment of fibromyalgia in Canada and the European Union, no NIBS method is currently approved for chronic pain in the United States. Increasing sample sizes in randomized clinical trials (RCTs) seems the most efficient way to increase confidence in initial promising results. Trends at funding agencies reveal increased interest and support for NIBS such as recent Requests for Application from the National Institutes of Health. NIBS in conjunction with cognitive behavioral therapy and physical therapy may enhance outcomes in chronic pain. Novel stimulation methods, such as transcranial ultrasound stimulation, await rigorous study in chronic pain.

Keywords: chronic pain; non-invasive brain stimulation; rTMS; repetitive transcranial magnetic stimulation; tDCS; transcranial direct current stimulation.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Timothy Meeker, Rithvic Jupudi, Frederik Lenz and Joel Greenspan declare no conflicts of interest relevant to this manuscript.

Figures

See this image and copyright information in PMC

Cited by

Brain stimulation targets for chronic pain: Insights from meta-analysis, functional connectivity and literature review.
Kong Q, Li T, Reddy S, Hodges S, Kong J. Kong Q, et al. Neurotherapeutics. 2024 Jan;21(1):e00297. doi: 10.1016/j.neurot.2023.10.007. Epub 2023 Dec 19. Neurotherapeutics. 2024. PMID: 38237403 Free PMC article. Review.
Prolonged continuous theta burst stimulation increases motor corticospinal excitability and intracortical inhibition in patients with neuropathic pain: An exploratory, single-blinded, randomized controlled trial.
Thakkar B, Peterson CL, Acevedo EO. Thakkar B, et al. Neurophysiol Clin. 2023 Aug;53(4):102894. doi: 10.1016/j.neucli.2023.102894. Epub 2023 Aug 31. Neurophysiol Clin. 2023. PMID: 37659135 Free PMC article. Clinical Trial.
Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum.
Duff IT, Krolick KN, Mahmoud HM, Chidambaran V. Duff IT, et al. J Clin Med. 2023 Aug 9;12(16):5176. doi: 10.3390/jcm12165176. J Clin Med. 2023. PMID: 37629218 Free PMC article.
Disentangling Diagnosis and Management of Fibromyalgia.
Kang JH, Choi SE, Park DJ, Lee SS. Kang JH, et al. J Rheum Dis. 2022 Jan 1;29(1):4-13. doi: 10.4078/jrd.2022.29.1.4. J Rheum Dis. 2022. PMID: 37476701 Free PMC article. Review.
Brain system segregation and pain catastrophizing in chronic pain progression.
Delgado-Gallén S, Soler MD, Cabello-Toscano M, Abellaneda-Pérez K, Solana-Sánchez J, España-Irla G, Roca-Ventura A, Bartrés-Faz D, Tormos JM, Pascual-Leone A, Cattaneo G. Delgado-Gallén S, et al. Front Neurosci. 2023 Mar 16;17:1148176. doi: 10.3389/fnins.2023.1148176. eCollection 2023. Front Neurosci. 2023. PMID: 37008229 Free PMC article.

See all "Cited by" articles

References

1. Tsubokawa T, Katayama Y, Yamamoto T, Hirayama T, Koyama S. Treatment of thalamic pain by chronic motor cortex stimulation. Pacing Clin Electrophysiol. 1991; 14( 1): 131–4. doi :10.1111/j.1540-8159.1991.tb04058.x. - DOI - PubMed
1. Lefaucheur JP. Cortical neurostimulation for neuropathic pain: state of the art and perspectives. Pain. 2016;157 Suppl 1:S81–9. doi: 10.1097/j.pain.0000000000000401. - DOI - PubMed
1. Kurt E, Henssen D, Steegers M, Staal M, Beese U, Maarrawi J et al. Motor Cortex Stimulation in Patients Suffering from Chronic Neuropathic Pain: Summary of Expert Meeting and Premeeting Questionnaire, Combined with Literature Review. World Neurosurg. 2017;108:254–63. doi:10.1016/j.wneu.2017.08.168. - DOI - PubMed
1. Arendsen LJ, Hugh-Jones S, Lloyd DM. Transcranial Alternating Current Stimulation at Alpha Frequency Reduces Pain When the Intensity of Pain is Uncertain. Journal of Pain. 2018;19(7):807–18. doi:10.1016/j.jpain.2018.02.014.
  *-This is the first study to show significant pain alleviating effects of transcranial alternating current stimulation (tACS) targeting the somatosensory cortex. The effect on acute phasic pain was specific to stimuli that were unexpected to the participant.
1. Wang P, Zhang J, Yu J, Smith C, Feng W. Brain Modulatory Effects by Low-Intensity Transcranial Ultrasound Stimulation (TUS): A Systematic Review on Both Animal and Human Studies. Frontiers in Neuroscience. 2019; 13(696). doi: 10.3389/fnins.2019.00696. - DOI - PMC - PubMed

Grants and funding

LinkOut - more resources

Full Text Sources
- Europe PubMed Central
- PubMed Central
Research Materials
- NCI CPTC Antibody Characterization Program

[1] Tsubokawa T, Katayama Y, Yamamoto T, Hirayama T, Koyama S. Treatment of thalamic pain by chronic motor cortex stimulation. Pacing Clin Electrophysiol. 1991; 14( 1): 131–4. doi :10.1111/j.1540-8159.1991.tb04058.x. - DOI - PubMed

[2] Tsubokawa T, Katayama Y, Yamamoto T, Hirayama T, Koyama S. Treatment of thalamic pain by chronic motor cortex stimulation. Pacing Clin Electrophysiol. 1991; 14( 1): 131–4. doi :10.1111/j.1540-8159.1991.tb04058.x. - DOI - PubMed

[3] Lefaucheur JP. Cortical neurostimulation for neuropathic pain: state of the art and perspectives. Pain. 2016;157 Suppl 1:S81–9. doi: 10.1097/j.pain.0000000000000401. - DOI - PubMed

[4] Lefaucheur JP. Cortical neurostimulation for neuropathic pain: state of the art and perspectives. Pain. 2016;157 Suppl 1:S81–9. doi: 10.1097/j.pain.0000000000000401. - DOI - PubMed

[5] Kurt E, Henssen D, Steegers M, Staal M, Beese U, Maarrawi J et al. Motor Cortex Stimulation in Patients Suffering from Chronic Neuropathic Pain: Summary of Expert Meeting and Premeeting Questionnaire, Combined with Literature Review. World Neurosurg. 2017;108:254–63. doi:10.1016/j.wneu.2017.08.168. - DOI - PubMed

[6] Kurt E, Henssen D, Steegers M, Staal M, Beese U, Maarrawi J et al. Motor Cortex Stimulation in Patients Suffering from Chronic Neuropathic Pain: Summary of Expert Meeting and Premeeting Questionnaire, Combined with Literature Review. World Neurosurg. 2017;108:254–63. doi:10.1016/j.wneu.2017.08.168. - DOI - PubMed

[7] Arendsen LJ, Hugh-Jones S, Lloyd DM. Transcranial Alternating Current Stimulation at Alpha Frequency Reduces Pain When the Intensity of Pain is Uncertain. Journal of Pain. 2018;19(7):807–18. doi:10.1016/j.jpain.2018.02.014.
*-This is the first study to show significant pain alleviating effects of transcranial alternating current stimulation (tACS) targeting the somatosensory cortex. The effect on acute phasic pain was specific to stimuli that were unexpected to the participant.

[8] Arendsen LJ, Hugh-Jones S, Lloyd DM. Transcranial Alternating Current Stimulation at Alpha Frequency Reduces Pain When the Intensity of Pain is Uncertain. Journal of Pain. 2018;19(7):807–18. doi:10.1016/j.jpain.2018.02.014.
*-This is the first study to show significant pain alleviating effects of transcranial alternating current stimulation (tACS) targeting the somatosensory cortex. The effect on acute phasic pain was specific to stimuli that were unexpected to the participant.

[9] Wang P, Zhang J, Yu J, Smith C, Feng W. Brain Modulatory Effects by Low-Intensity Transcranial Ultrasound Stimulation (TUS): A Systematic Review on Both Animal and Human Studies. Frontiers in Neuroscience. 2019; 13(696). doi: 10.3389/fnins.2019.00696. - DOI - PMC - PubMed

[10] Wang P, Zhang J, Yu J, Smith C, Feng W. Brain Modulatory Effects by Low-Intensity Transcranial Ultrasound Stimulation (TUS): A Systematic Review on Both Animal and Human Studies. Frontiers in Neuroscience. 2019; 13(696). doi: 10.3389/fnins.2019.00696. - DOI - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

New Developments in Non-invasive Brain Stimulation in Chronic Pain

Affiliations

New Developments in Non-invasive Brain Stimulation in Chronic Pain

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Grants and funding

LinkOut - more resources

Full Text Sources

Research Materials

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Research Materials