Korean J Pain.  2014 Jul;27(3):285-289. 10.3344/kjp.2014.27.3.285.

Repetitive Transcranial Magnetic Stimulation to Treat Depression and Insomnia with Chronic Low Back Pain

• Park EJ
• Lee SJ
• Koh DY
• Han YM

• KMID: 2278241
• DOI: http://doi.org/10.3344/kjp.2014.27.3.285

Abstract

Transcranial magnetic stimulation (TMS) is a noninvasive and safe technique for motor cortex stimulation. TMS is used to treat neurological and psychiatric disorders, including mood and movement disorders. TMS can also treat several types of chronic neuropathic pain. The pain relief mechanism of cortical stimulation is caused by modifications in neuronal excitability. Depression is a common co-morbidity with chronic pain. Pain and depression should be treated concurrently to achieve a positive outcome. Insomnia also frequently occurs with chronic lower back pain. Several studies have proposed hypotheses for TMS pain management. Herein, we report two cases with positive results for the treatment of depression and insomnia with chronic low back pain by TMS.

Keyword

back pain; chronic pain; depression; insomnia; transcranial magnetic stimulation

MeSH Terms

Back Pain
Chronic Pain
Depression*
Low Back Pain*
Motor Cortex
Movement Disorders
Neuralgia
Neurons
Pain Management
Sleep Initiation and Maintenance Disorders*
Transcranial Magnetic Stimulation*

Figure

• 

  Fig. 1 (A) Transcranial magnetic stimulation machine delivers the electric currents to the brain through the magnetic stimulator coil. (B) A figure-of-eight-shaped coil magnetic stimulator is placed on the skull overlying the left prefrontal cortex.

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  Fig. 2 (A) Change in NRS after the TMS. (B) Change in BDI after the TMS. (C) Change in ISI after the TMS. (D) Change in PDI after the TMS. BDI: Beck depression inventory (0-63), ISI: insomnia severity index (0-28), NRS: numerical rating scale (0-100), PDI: pain disability index (0-70), TMS: transcranial magnetic stimulation.

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