Neuropathic Pain
DRUG TREATMENT
In terms of treating neuropathic pain, drug therapy nowadays is relatively ineffective. Traditional analgesics such as paracetamol or some non-steroidal anti-inflammatory drugs are not effective in relieving pain caused by dysfunctions of the nervous system.
Some psychiatrists have suggested using some psychiatric drugs, such as tricyclic antidepressants (TCA) or antiepileptics in relieving neuropathic pain. Although in some cases, these drugs appeared to be more effective than traditional analgesics, these psychiatric drugs bring a lot of side effects at the same time. Therefore, using psychiatric drugs to treat neuropathic pain is not widely adopted in the United States and Europe.
TMS TREATMENT
For neuropathic pain that cannot be relieved by drugs, TMS can be a possible option. TMS is an effective and non-invasive technique to treat a variety of neurological diseases.
By combining TMS with 3D brain imaging, the navigation system can accurately identify the target areas of the motor cortex, which allows precise stimulation. TMS can play a significant analgesic effect This is helpful in relieving chronic neuropathic pain.
Reference
Haanpää, M. & Treede, R.D. (2010). Diagnosis and classification of neuropathic pain. Pain: Clinical Updates,18(7).
Lefaucheur, J.P. et al. (2014). Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol, 125(11):2150-206.https://www.ncbi.nlm.nih.gov/pubmed/25034472
Nurmikko,T. et al.(2016). Motor Cortex Reorganization and Repetitive Transcranial Magnetic Stimulation for Pain-A Methodological Study. Neuromodulation,19(7):669-678.
Treede, R.D., Jensen, T.S., Campbell. J.N., Cruccu, G., Dostrovsky, J.O., Griffin, J.W., Hansson, P., Hughes, R.,Nurmikko, T.,& Serra J.(2008). Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology,70,1630–5.
Other
Ahdab R, Lefaucheur JP 2nd International Symposium on Navigated Brain Stimulation in Neurosurgery Charité – Universitätsmedizin Berlin (Organizer) 2011 May; 34-36
Mylius V, Lefaucheur JP 3rd International Symposium on Navigated Brain Stimulation in Neurosurgery Charité – Universitätsmedizin Berlin (Organizer) 2012 May; 27-29
Nurmikko TJ, Sacco P 3rd International Symposium on Navigated Brain Stimulation in Neurosurgery Charité – Universitätsmedizin Berlin (Organizer) 2012 May; 23-26
Nurmikko TJ, Sacco P 5th International Symposium on Navigated Brain Stimulation in Neurosurgery Charité – Universitätsmedizin Berlin (Organizer) 2014 June; 32-36
Stroke Rehabilitation
Stroke is a type of cerebrovascular disease. Due to the infarction or bleeding of blood vessels in the brain, the brain tissue fails to get adequate oxygen and nutrients in time. The affected nerve cells are therefore permanently damaged, which in turn leads to various dysfunctions in body parts.
Symptoms of stroke may vary depending on the location and extent of damage to the brain, but the general symptoms are as follows:
- Weakness or numbness of the face, arm, or leg on one side of the body
- Loss of vision or dimming (like a curtain falling) in one or both eyes
- Loss of speech, difficulty in talking and swallowing
- Loss of balance or inability in walking
- Incontinence
Complications include:
- Limb motor dysfunction
- Limb sensory dysfunction
- Language disability
- Dysphagia, etc.
STROKE REHABILITATION
Patients suffering from stroke experience enormous difficulties in daily living. Their cognitive and motor functions are greatly inhibited. Studies have shown that even if the stroke patient receives timely emergency treatment, there will still be 15% to 30% of physical disabilities.
At present, patients with stroke have only relied on physiotherapy for rehabilitation, but it has failed to address the main cause of physical disability – the impairments in patients’ brains.
In view of this, TMS, which is a non-invasive technology that can directly stimulate the brain and modulate neuroactivities, is currently the focus of clinical research to assist patients with stroke rehabilitation.
TMS AND STROKE REHABILITATION
TMS can regulate the cortical excitability of the cerebral cortex. This technology can selectively enhance or inhibit the function of specific regions of the brain to achieve regulation of brain function and neuroplasticity, thereby improving stroke patients’ cognitive and motor functioning.
In summary, clinical research finds that TMS can:
- Improve the excitability of the damaged part of the brain, accelerating the recovery time of the injury site
- Inhibit the non-injury parts of the brain, giving the injured area a better chance of repair
- Inhibit the non-injury sites in the brain, enhancing the response rate in patients with stroke
*Declaration: The application of TMS to stroke rehab is still experimental. Although some clinical studies have achieved positive results, this clinical application has not yet obtained FDA approval and CE mark.
Irritable bowel syndrome
Irritable bowel syndrome, or what is commonly referred to as “intestinal sensitivity” refers to intestinal dysfunction, which causes gastrointestinal motility to become uncoordinated.
The symptoms of Irritable Bowel Syndrome include:
- Stomachache
- Constipation
- Abdominal flatulence
- Diarrhea
- Unclear faeces
CAUSES OF IRRITABLE BOWEL SYNDROME
To date, the medical field still does not have a clear understanding of the pathogenic causes of irritable bowel, but more and more medical studies have shown that functional gastrointestinal diseases are closely related to emotional diseases.
The irritable bowel condition is also strongly related to the patient’s mood and stress. In summary, here are a few factors that are prone to cause illness:
- Neurotic and anxious disposition
- Exposure to long-term pressure
- Bad eating habits
- Menstruation
- Emotional instability
TMS AND IRRITABLE BOWEL SYNDROME
Although the clinical application of TMS for direct treatment of irritable bowel syndrome is still experimental, recent clinical studies have found that brain magnetic stimulation is effective in improving chronic pain in patients with rectal hypersensitivity.
In addition, gastrointestinal sensitivity is found to be closely related to anxiety and stress. TMS has a significant effect on relieving anxiety. Therefore, patients with long-term gastrointestinal problems can seek their doctors for professional advice regarding using TMS as a possible treatment.
Reference:
Melchior, C., Gourcerol, G., Chastan, N., Verin, E., Menard, J.F., Ducrotte, P., Leroi, A.M. (2013). Effect of transcranial magnetic stimulation on rectal sensitivity in irritable bowel syndrome: a randomized, placebo-controlled pilot study. Colorectal Disease, 16(3), 104-111.
*Declaration: The application of TMS to Tinnitus is still experimental. Although some clinical studies have achieved positive results, this clinical application has not yet obtained FDA approval and CE mark.