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NEUROLOGY 2004;62:2176-2181
© 2004 American Academy of Neurology

Facilitation of A{delta}-fiber-mediated acute pain by repetitive transcranial magnetic stimulation

Y. Tamura, MD, M. Hoshiyama, MD PhD, K. Inui, MD PhD, H. Nakata, BS, Y. Qiu, MD, Y. Ugawa, MD PhD, K. Inoue, MD PhD and R. Kakigi, MD PhD

From the Department of Integrative Physiology (Drs. Tamura, Hoshiyama, Inui, Qiu, and Kakigi, H. Nakata), National Institute for Physiological Sciences, Okazaki, Japan; Department of Neurology (Drs. Tamura and Inoue), Jikei University School of Medicine, Tokyo, Japan; Department of Health Sciences (Dr. Hoshiyama), Faculty of Medicine, Nagoya University, Japan; Department of Neurology, Division of Neuroscience (Dr. Ugawa), Graduate School of Medicine, University of Tokyo, Japan.

Address correspondence and reprint requests to Dr. Yohei Tamura, Department of Integrative Physiology, National Institute for Physiological Sciences, Myodaiji, Okazaki 444-8585, Japan; e-mail: ytamura{at}nips.ac.jp

Background: Repetitive transcranial magnetic stimulation (rTMS) of the motor cortex modulates acute and chronic pain perception. The authors previously showed that rTMS over the primary motor cortex (M1) inhibited capsaicin-induced acute pain ascending through C-fibers. Objective: To investigate the effects of 1-Hz rTMS over M1 on acute experimentally induced pain mediated by A{delta}-fibers (i.e., another type of acute pain).

Methods: The authors examined whether rTMS over M1 affected laser evoked potentials (LEPs) in 13 normal subjects using thulium: yttrium-aluminum-garnet laser stimulation. Subjective pain-rating scores and LEPs obtained under three different conditions—rTMS, realistic sham stimulation, and a control condition with no stimulation—were compared.

Results: The authors found that 1-Hz rTMS over M1 significantly aggravated the subjective pain and enhanced the N2-P2 amplitudes compared with the sham or control sessions. Because the pain-rating scores and the N2-P2 amplitudes correlated positively, the N2-P2 amplitudes in the present study can be regarded as the cortical correlate of subjective pain.

Conclusions: Together with the authors’ previous study on C-fiber pain, this facilitatory effect of repetitive transcranial magnetic stimulation on A{delta}-fiber-mediated further strengthens the notion of a relationship between repetitive transcranial magnetic stimulation over M1 and pain perception.

Received November 10, 2003. Accepted in final form February 18, 2004.






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