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PhD Seminar – Neuroplasticity of the Pain Modulation System: Lessons from TMS and Functional Neuroimaging in Fibromyalgia

27/08/2019 @ 09:00 - 11:00 IDT

Repetitive transcranial magnetic stimulation of the motor cortex (M1-rTMS) is a non-invasive neuromodulation treatment that provides long-term clinical pain relief and improvement in quality-of-life in fibromyalgia syndrome (FMS) patients. However, little is known about the neurophysiological infrastructure underlying this effect. Twenty-seven female FMS patients, ages 19-55, participated in this double-blind, cross-over, sham-controlled study. Patients underwent 2 sets of 10 daily treatments of either real or sham M1-rTMS, in a counter-balanced order. We examined the relationship between treatment response and brain structure and connectivity. We found that: 1) treatment response was significant only following real, but not sham, M1-rTMS; 2) resting-state functional connectivity (rsFC) of pain-related brain areas, and resting-state networks (RSNs) implicated in FMS predicted treatment response; and 3) treatment response was accompanied by changes in the rsFC of RSNs and pain processing areas, with a partial overlap to the regions predicting the treatment response. Also, depression and pain catastrophizing levels were independent from improvements in clinical pain, daily function and pain affect. Gray matter volume and white matter integrity did not predict or change along with treatment response. In conclusion, we suggest that the individual ability to benefit from neuromodulation in primary chronic pain diseases, i.e. FMS, relies on widespread functional changes in the dynamic pain connectome.


09:00 - 11:00
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