IntroductionWhile the efficacy of repetitive transcranial magnetic stimulation (rTMS) of the motor cortex to alleviate neuropathic pain appears now well established (Lefaucheur et al., ; O'Connell et al., ; Jin et al., ; Cruccu et al., ; Moisset et al., ), the possible influence of its somatotopic localization within the motor cortex remains controversial. Pioneering studies using neurosurgically implanted, epidural motor cortex stimulation (MCS) suggested that pain relief was tightly correlated to the somatotopic targeting of the cortical representation of the body part concerned by pain (Nguyen et al., ; Saitoh et al., ; Cioni and Meglio, ), which prompted investigators using noninvasive rTMS to target somatotopically the motor areas corresponding to the painful symptoms. This approach was challenged, however, by reports suggesting that pain relief was best obtained when rTMS was applied to the cortical territory adjacent to that of the painful body part (Lefaucheur et al., , ), and describing better results for facial pain when stimulation was targeted on the hand cortical area. Results were also controversial for lower limb pain, since rTMS over the hand cortical area was sometimes described as ineffective (Kang et al., ) while more recent reports described equivalent effects of leg and hand area stimulation for lower limb pain (Jette
European Journal of Pain – Wiley
Published: Jan 1, 2018
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