What is the role of magnetic stimulation in the treatment of complex regional pain syndrome (CRPS)?

Updated: Jun 20, 2018
  • Author: Gaurav Gupta, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Transcranial magnetic stimulation (TMS) is a non-invasive procedure for stimulation of the motor cortex. TMS has been used to study the physiological characteristics of CRPS type I. Through TMS, sensory and motor hyperexcitability is demonstrated bilaterally in neurons of the cerebral cortex, and localizing to regions corresponding to the affected limb within the central nervous system rather than the entire hemisphere. [155] TMS may also have therapeutic benefit. Pleger et al. studied the analgesic efficiency of repetitive transcranial magnetic simulation applied to the motor cortex contralateral to the CRPS-affected side. Seven out of ten patients reported decreased pain intensities, with maximum effect 15 mins after stimulation was initiated. [156] Peripheral magnetic stimulation has also been demonstrated to increased osteoclast apoptosis, osteoblast viability, bone protein and matrix calcification, antioxidant protein, and the levels of adenosine receptors, while it decreased the levels of pro-inflammatory cytokines. These findings indicate a potential therapeutic benefit to address the impairments in bone function and elevation of pro-inflammatory cytokines observed in CRPS. Further studies are needed to explore the therapeutic role of magnetic stimulation in CRPS patients. [157]


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