Discover how the cutting-edge approach of high-frequency neuronavigated repetitive transcranial magnetic stimulation offers new hope for alleviating post-stroke shoulder pain, as revealed in the latest double-blinded, randomized controlled study.
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High frequency neuronavigated repetitive transcranial magnetic stimulation in post-stroke shoulder pain: A double-blinded, randomized controlled study.
Aydin et al., J Stroke Cerebrovasc Dis 2024
DOI: 10.1016/j.jstrokecerebrovasdis.2024.107562
Study Summary:
The study investigated the impact of high-frequency (5Hz) neuronavigated repetitive transcranial magnetic stimulation (rTMS) on post-stroke shoulder pain and associated functional limitations. A total of 22 patients were divided into two groups: the experimental group (n=7) received real rTMS to the affected primary motor cortex (M1), while the control group (n=11) received sham stimulation. The treatment was administered five times a week for three weeks, totaling 15 sessions.
Outcomes measured included pain intensity (NRS), pain’s effect on daily activities (BPI), disability (Quick DASH), mood (HADS), shoulder joint range of motion (ROM), and neurophysiological parameters. These were assessed at multiple time points: before treatment, after the 5th, 10th, and 15th sessions, and four weeks post-treatment.
Key Findings:
- No significant difference in pain intensity (NRS) between or within groups.
- The rTMS group showed lower BPI scores initially and after the final session (T0 and T3), but no significant change over time within each group.
- Quick-DASH scores were significantly lower in the rTMS group four weeks post-treatment (T4).
- A significant improvement in shoulder external rotation was observed in the rTMS group at T3 compared to baseline (T0), but the magnitude of change was not different between groups.
- No significant changes in other ROM measurements or neurophysiological parameters were observed.
Conclusion:
The application of high-frequency rTMS to the affected M1 did not demonstrate significant benefits over sham stimulation for pain, activities of daily living, disability, mood, neurophysiological measurements, or passive ROM in patients with post-stroke shoulder pain.
Significance:
This study contributes to the literature by providing evidence on the effectiveness of rTMS for post-stroke shoulder pain, suggesting that while certain measures like the BPI and Quick-DASH showed some improvement, overall benefits were not significant compared to sham treatment.