Facilitation of Aδ-fiber-mediated acute pain by repetitive transcranial magnetic stimulation

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 Aδ-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 Aδ-fiber-mediated further strengthens the notion of a relationship between repetitive transcranial magnetic stimulation over M1 and pain perception.

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