Repetitive transcranial magnetic stimulation for intractable pain

Abstract

Electrical motor cortex stimulation (EMCS) for the treatment of pain is approved and supported by health insurance in Japan. However, EMCS requires a craniotomy, and some patients hesitate to undertake EMCS. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method of pain control, and the efficacy of rTMS has been evaluated in several studies. However, the effect of rTMS is temporary, and the response rate is 20-50 %. Therefore, it may be possible to treat intractable pain by selecting the responders and repeating rTMS. We are developing a convenient system to repeat rTMS. In December 2015, an investigator-initiated trial began with a new rTMS machine.