Modulation der Kalt-Warm-Wahrnehmung durch zerebelläre repetitive transkranielle Magnetstimulation (rTMS) - Ergebnisse einer Pilotstudie

Zusammenfassung

Anliegen Chronische Schmerzzustände resultieren aus einer dysfunktionalen Prozessierung innerhalb kortikaler Netzwerke. Es soll untersucht werden, ob durch eine repetitive transkranielle Magnetstimulation des Zerebellums die Schmerzwahrnehmung moduliert werden kann. Methode Quantitative sensorische Testung vor und nach 1-Hz- bzw. 10-Hz-rTMS des Zerebellums bei 4 Probanden. Ergebnisse Eine zerebelläre Stimulation veränderte die Wahrnehmungsschwellen und senkte die Kälteschmerzschwelle signifikant. Schlussfolgerungen rTMS des Zerebellums kann zu einer Änderung der Schmerzwahrnehmung führen.

Abstract

Objective Chronic pain syndromes often constitute a therapeutic dilemma characterized by drug resistance or abuse of pain relievers. According to recent studies, chronic pain states result from a dysfunctional processing within a complex cortical-subcortical network including frontal cortical regions, the thalamus and the cerebellum. Modulation of this network activity might hold potential of pain attenuation in chronic pain states. Repetitive transcranial magnetic stimulation (rTMS) has been shown to effectively change neuronal activity in distributed cortical circuits. Based on these findings, we investigated whether rTMS of the cerebellum leads to altered pain sensation by modulating this network. Methods Quantitative sensory testing before and after 1 Hz and 10 Hz neuronavigated rTMS of the cerebellum in 4 adult healthy volunteers. Results Cerebellar stimulation led to alteration of sensory thresholds and attenuation of cold pain sensation. Conclusions These results demonstrate that rTMS of the cerebellum is able to modulate pain sensation. Whether this treatment modality is clinically effective in chronic pain states has to be addressed in further studies.

Kleinhirnstimulation - repetitive transkranielle Magnetstimulation - Schmerzwahrnehmung

cerebellar stimulation - repetitive transcranial magnetic stimulation - pain perception

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