Pain Clinical Trial
Official title:
Efficacy of rTMS (Repetitive Transcranial Magnetic Stimulation) on Patients With Somatoform Pain Disorder
Chronic somatoform pain is common in psychiatric patients. Chronic somatoform pain causes
significant distress and disrupts social functioning. Moreover, chronic somatoform pain
often does not sufficiently respond to medication.
Chronic somatoform pain is associated with medial pain system. The medial pain system is
comprised of structures engaged in affect and motivation, such as medial thalamus and limbic
structures. The medial pain system gets inhibitory control from motor cortex. Functional
neuroimaging studies indicate that chronic somatoform pain is associated with hypoactivity
of motor cortex, defective inhibitory process, and hyperactivity of medial pain system.
Repetitive Transcranial Magnetic Stimulation (rTMS) is a safe and non-invasive tool to
modulate neurophysiologic activity of the focal brain. Therefore, pain relief by rTMS can be
obtained from motor cortex stimulation, restoration of defective inhibitory process, and
deactivation of medial pain system. Studies have shown that motor cortex stimulation using
rTMS can relieve pain in patients with neuropathic pain. However, to our knowledge, there is
no rTMS study on chronic somatoform pain in psychiatric patients. The purpose of this study
is to evaluate the effect of motor cortex rTMS on chronic somatoform pain.
Chronic somatoform pain is common in psychiatric patients. Chronic somatoform pain causes
significant distress and disrupts social functioning. Moreover, chronic somatoform pain
often does not sufficiently respond to medication.
Chronic somatoform pain is associated with medial pain system. The medial pain system is
comprised of structures engaged in affect and motivation, such as medial thalamus and limbic
structures. The medial pain system gets inhibitory control from motor cortex. Functional
neuroimaging studies indicate that chronic somatoform pain is associated with hypoactivity
of motor cortex, defective inhibitory process, and hyperactivity of medial pain system.
Repetitive Transcranial Magnetic Stimulation (rTMS) is a safe and non-invasive tool to
modulate neurophysiologic activity of the focal brain. Therefore, pain relief by rTMS can be
obtained from motor cortex stimulation, restoration of defective inhibitory process, and
deactivation of medial pain system. Studies have shown that motor cortex stimulation using
rTMS can relieve pain in patients with neuropathic pain. However, to our knowledge, there is
no rTMS study on chronic somatoform pain in psychiatric patients. The purpose of this study
is to evaluate the effect of motor cortex rTMS on chronic somatoform pain.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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