Navigated rTMS for the treatment of pain

Abstract

Neuropathic pain is a very common burden of society. Although treatment options are various, their success is also limited. Cortical stimulation, which started with invasive epidural approach, first showed sufficient long-term analgesia in about half of the patients with chronic neuropathic pain, resistant to medication prior to implantation. More recently, noninvasive brain stimulation also proved to be effective in the treatment of these patients via rTMS delivered to the motor cortex. In addition, nTMS and nrTMS can be used to determine patient responsiveness and the most suitable site for subsequent electrode implantation. The following chapter outlines these noninvasive approaches to treat neuropathic pain focusing on neuroanatomical and methodological issues.