Pain Relief Clinical Trial
Official title:
Can Daily Sessions of rTMS to the Left DLPFC Boost Diffuse Noxious Inhibitory Control and Pain Thresholds in Healthy Subjects
The main purpose of the study is to assess whether repeated sessions of repetitive trancranial magnetic stimulation (rTMS) applied on left dorsolateral prefrontal cortex main boost the pain thresholds.
Pain is the largest health-related burden on society and, despite many decades of pain
research, there are still few effective treatments. Since pain experience is a construct of
the central nervous system (CNS), chronic pain has been recently thought to be a CNS
disorder.
Repetitive transcranial magnetic stimulation (rTMS) is a safe, non-invasive technique for
cerebral cortex stimulation and the clinical applications of which have expanded considerably
in recent years. Recent studies have been shown that 'classical' rTMS to different cortical
areas temporary reduce chronic and acute pain, suggesting that rTMS may ´have some clinical
application in future management of chronic pain. However, new rTMS paradigms involving theta
burst stimulation (TBS) have recently been described with the major clinical advantage to be
much shorter than 'classical' rTMS. The investigators hypothesize that cTBS would yield
analgesic effects similar to or, possibly, even stronger than those produced by 'classical'
rTMS. The investigators will carry out a sham-controlled, randomized, double-blind, crossover
study in healthy volunteers, to compare the analgesic effects of two rTMS protocols over
dorsolateral prefrontal cortex: classical high-frequency rTMS (10 Hz), and TBS. As
rTMS-induced analgesia may be dependent on changes in pain modulatory systems, the
investigators will analyze the effects of the stimulation on conditioned pain modulation
(CPM). More specifically, the investigators will compare the effects of multiple sessions of
rTMS on the inhibition of a test experimental stimulus induced by heterotopic noxious
stimuli, to assess possible changes in diffuse noxious inhibitory controls.
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