PMID- 24865417
OWN - NLM
STAT- MEDLINE
DCOM- 20150331
LR  - 20220408
IS  - 1528-8447 (Electronic)
IS  - 1526-5900 (Linking)
VI  - 15
IP  - 8
DP  - 2014 Aug
TI  - Repetitive transcranial magnetic stimulation increases the corticospinal 
      inhibition and the brain-derived neurotrophic factor in chronic myofascial pain 
      syndrome: an explanatory double-blinded, randomized, sham-controlled trial.
PG  - 845-55
LID - S1526-5900(14)00723-8 [pii]
LID - 10.1016/j.jpain.2014.05.001 [doi]
AB  - Chronic myofascial pain syndrome has been related to defective descending 
      inhibitory systems. Twenty-four females aged 19 to 65 years with chronic 
      myofascial pain syndrome were randomized to receive 10 sessions of repetitive 
      transcranial magnetic stimulation (rTMS) (n = 12) at 10 Hz or a sham intervention 
      (n = 12). We tested if pain (quantitative sensory testing), descending inhibitory 
      systems (conditioned pain modulation [quantitative sensory testing + conditioned 
      pain modulation]), cortical excitability (TMS parameters), and the brain-derived 
      neurotrophic factor (BDNF) would be modified. There was a significant interaction 
      (time vs group) regarding the main outcomes of the pain scores as indexed by the 
      visual analog scale on pain (analysis of variance, P < .01). Post hoc analysis 
      showed that compared with placebo-sham, the treatment reduced daily pain scores 
      by -30.21% (95% confidence interval = -39.23 to -21.20) and analgesic use by 
      -44.56 (-57.46 to -31.67). Compared to sham, rTMS enhanced the corticospinal 
      inhibitory system (41.74% reduction in quantitative sensory testing + conditioned 
      pain modulation, P < .05), reduced the intracortical facilitation in 23.94% (P = 
      .03), increased the motor evoked potential in 52.02% (P = .02), and presented 
      12.38 ng/mL higher serum BDNF (95% confidence interval = 2.32-22.38). No adverse 
      events were observed. rTMS analgesic effects in chronic myofascial pain syndrome 
      were mediated by top-down regulation mechanisms, enhancing the corticospinal 
      inhibitory system possibly via BDNF secretion modulation. PERSPECTIVE: 
      High-frequency rTMS analgesic effects were mediated by top-down regulation 
      mechanisms enhancing the corticospinal inhibitory, and this effect involved an 
      increase in BDNF secretion.
CI  - Copyright (c) 2014 American Pain Society. Published by Elsevier Inc. All rights 
      reserved.
FAU - Dall'Agnol, Letizzia
AU  - Dall'Agnol L
AD  - Postgraduate Program in Medical Sciences, School of Medicine, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Pain and 
      Neuromodulation, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
FAU - Medeiros, Liciane Fernandes
AU  - Medeiros LF
AD  - Postgraduate Program in Medical Sciences, School of Medicine, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil; Postgraduate Program in 
      Biologic Sciences: Physiology, Institute of Basic Health Sciences, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Pain and 
      Neuromodulation, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
FAU - Torres, Iraci L S
AU  - Torres IL
AD  - Postgraduate Program in Medical Sciences, School of Medicine, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil; Postgraduate Program in 
      Biologic Sciences: Physiology, Institute of Basic Health Sciences, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil; Pharmacology Department, 
      Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, 
      Porto Alegre, Brazil; Laboratory of Pain and Neuromodulation, Hospital de 
      Clinicas de Porto Alegre, Porto Alegre, Brazil.
FAU - Deitos, Alicia
AU  - Deitos A
AD  - Postgraduate Program in Medical Sciences, School of Medicine, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Pain and 
      Neuromodulation, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
FAU - Brietzke, Aline
AU  - Brietzke A
AD  - Postgraduate Program in Medical Sciences, School of Medicine, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil; Laboratory of Pain and 
      Neuromodulation, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
FAU - Laste, Gabriela
AU  - Laste G
AD  - Postgraduate Program in Medical Sciences, School of Medicine, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil; Postgraduate Program in 
      Biologic Sciences: Physiology, Institute of Basic Health Sciences, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil.
FAU - de Souza, Andressa
AU  - de Souza A
AD  - Laboratory of Pain and Neuromodulation, Hospital de Clinicas de Porto Alegre, 
      Porto Alegre, Brazil; Pain and Palliative Care Service at Hospital de Clinicas de 
      Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, 
      Brazil.
FAU - Vieira, Julia Lima
AU  - Vieira JL
AD  - Laboratory of Pain and Neuromodulation, Hospital de Clinicas de Porto Alegre, 
      Porto Alegre, Brazil.
FAU - Fregni, Felipe
AU  - Fregni F
AD  - Spaulding Center of Neuromodulation, Department of Physical Medicine and 
      Rehabilitation, Harvard Medical School, Boston, Massachusetts.
FAU - Caumo, Wolnei
AU  - Caumo W
AD  - Postgraduate Program in Medical Sciences, School of Medicine, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, Brazil; Pharmacology Department, 
      Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, 
      Porto Alegre, Brazil; Laboratory of Pain and Neuromodulation, Hospital de 
      Clinicas de Porto Alegre, Porto Alegre, Brazil; Pain and Palliative Care Service 
      at Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do 
      Sul (UFRGS), Porto Alegre, Brazil. Electronic address: caumo@cpovo.net.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20140524
PL  - United States
TA  - J Pain
JT  - The journal of pain
JID - 100898657
RN  - 0 (Analgesics)
RN  - 0 (Brain-Derived Neurotrophic Factor)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Analgesics/pharmacology/therapeutic use
MH  - Brain-Derived Neurotrophic Factor/*blood
MH  - Chronic Disease
MH  - Double-Blind Method
MH  - Evoked Potentials, Motor/physiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - *Inhibition, Psychological
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Myofascial Pain Syndromes/*blood/drug therapy/*therapy
MH  - Pain Measurement
MH  - Pyramidal Tracts/*physiology
MH  - Sleep/drug effects/physiology
MH  - Transcranial Magnetic Stimulation/*methods
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Myofascial pain syndrome
OT  - brain-derived neurotrophic factor
OT  - clinical trial
OT  - quantitative sensory testing
OT  - transcranial magnetic simulation
EDAT- 2014/05/29 06:00
MHDA- 2015/04/01 06:00
CRDT- 2014/05/29 06:00
PHST- 2014/03/25 00:00 [received]
PHST- 2014/05/11 00:00 [revised]
PHST- 2014/05/13 00:00 [accepted]
PHST- 2014/05/29 06:00 [entrez]
PHST- 2014/05/29 06:00 [pubmed]
PHST- 2015/04/01 06:00 [medline]
AID - S1526-5900(14)00723-8 [pii]
AID - 10.1016/j.jpain.2014.05.001 [doi]
PST - ppublish
SO  - J Pain. 2014 Aug;15(8):845-55. doi: 10.1016/j.jpain.2014.05.001. Epub 2014 May 
      24.