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A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
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Pain.

Jean-Pascal Lefaucheur1

  • 1Faculty of Medicine, Université Paris Est Créteil and Service de Physiologie, Explorations Fonctionnelles, Hôpital Henri Mondor, Créteil, France.

Handbook of Clinical Neurology
|October 12, 2013
PubMed
Summary
This summary is machine-generated.

Motor cortex stimulation (MCS) treats refractory neuropathic pain. Noninvasive techniques like repetitive transcranial magnetic stimulation (rTMS) may predict MCS success and offer standalone pain relief.

Keywords:
chronic painepidural cortical stimulationmotor cortexneuromodulationneuropathic painnoninvasive brain stimulationprefrontal cortexrefractory painrepetitive transcranial magnetic stimulationtranscranial direct current stimulation

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Area of Science:

  • Neuroscience
  • Neurology
  • Pain Management

Background:

  • Epidural motor cortex stimulation (MCS) is used for refractory neuropathic pain.
  • MCS efficacy is proven, but outcomes vary, and patient selection criteria are lacking.
  • Noninvasive brain stimulation techniques offer potential as predictive or therapeutic tools.

Purpose of the Study:

  • To explore the role of noninvasive brain stimulation, specifically repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), in predicting and treating pain.
  • To discuss the mechanisms of analgesic effects of cortical stimulation.
  • To highlight ongoing developments in neuromodulation for pain management.

Main Methods:

  • Review of controlled trials demonstrating MCS efficacy for neuropathic pain.
  • Discussion of repetitive transcranial magnetic stimulation (rTMS) as a preoperative predictive tool and therapeutic option.
  • Exploration of transcranial direct current stimulation (tDCS) for chronic pain, including various cortical targets.

Main Results:

  • MCS is effective for refractory neuropathic pain, but patient selection remains a challenge.
  • rTMS shows potential as a noninvasive method to predict MCS outcomes.
  • tDCS has demonstrated efficacy in relieving chronic pain syndromes, with targets beyond the motor cortex.

Conclusions:

  • Noninvasive brain stimulation techniques like rTMS and tDCS are promising for optimizing pain management strategies.
  • Further research is needed to refine patient selection for MCS and establish protocols for noninvasive stimulation therapies.
  • Cortical stimulation modulates neural circuits, offering a pathway for treating diverse pain conditions.