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Review
. 2022 May 19:15:879909.
doi: 10.3389/fnmol.2022.879909. eCollection 2022.

Non-invasive Brain Stimulation for Central Neuropathic Pain

Qi-Hao Yang  1 , Yong-Hui Zhang  1 , Shu-Hao Du  1 , Yu-Chen Wang  1 , Yu Fang  2 , Xue-Qiang Wang  1   3
Affiliations
Review

Non-invasive Brain Stimulation for Central Neuropathic Pain

Qi-Hao Yang et al. Front Mol Neurosci. .

Abstract

The research and clinical application of the noninvasive brain stimulation (NIBS) technique in the treatment of neuropathic pain (NP) are increasing. In this review article, we outline the effectiveness and limitations of the NIBS approach in treating common central neuropathic pain (CNP). This article summarizes the research progress of NIBS in the treatment of different CNPs and describes the effects and mechanisms of these methods on different CNPs. Repetitive transcranial magnetic stimulation (rTMS) analgesic research has been relatively mature and applied to a variety of CNP treatments. But the optimal stimulation targets, stimulation intensity, and stimulation time of transcranial direct current stimulation (tDCS) for each type of CNP are still difficult to identify. The analgesic mechanism of rTMS is similar to that of tDCS, both of which change cortical excitability and synaptic plasticity, regulate the release of related neurotransmitters and affect the structural and functional connections of brain regions associated with pain processing and regulation. Some deficiencies are found in current NIBS relevant studies, such as small sample size, difficulty to avoid placebo effect, and insufficient research on analgesia mechanism. Future research should gradually carry out large-scale, multicenter studies to test the stability and reliability of the analgesic effects of NIBS.

Keywords: analgesic effects; analgesic mechanism; central neuropathic pain; rTMS; tDCS.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
The common diseases that cause central neuropathic pain. Stroke, Parkinson’s disease, multiple sclerosis, and spinal cord injury often lead to central neuropathic pain that persists throughout the recovery cycle. This pain clearly has a negative effect on the prognosis of patients.
FIGURE 2
FIGURE 2
The neurophysiological mechanisms of rTMS. NMDA, N-methyl-D-aspartate receptor; LTP, long-term potentiation; IL, interleukin; TNF, tumor necrosis factor; Bcl, B-cell lymphoma; Bax, Bcl2-associated X; NSCs, neural stem cells; DRD2, dopamine receptor D2.
FIGURE 3
FIGURE 3
The neurophysiological mechanisms of tDCS. NMDAR, N-methyl-D-aspartate receptor; GABA, gamma-aminobutyric acid; P2X4, purinoceptor 4.
FIGURE 4
FIGURE 4
The common mechanisms of NIBS analgesia on CNP. The analgesic mechanism of rTMS is similar to that of tDCS, both of which change cortical excitability and synaptic plasticity, regulate the release of related neurotransmitters, and affect the structural and functional connections of brain regions associated with pain processing and regulation.
See this image and copyright information in PMC

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