Supplementary Table 1 Noninvasive brain stimulation and chronic pain.a
Reference
Lefaucheur
et al.
(2001)1
Lefaucheur
et al.
(2001)2
Stimulation
site
M1
corresponding
to the painful
area
M1
corresponding
to the painful
area
Canavero et
al. (2002)3
M1
corresponding
to the painful
area
Brighina et
al. (2004)4
Left
dorsolateral
prefrontal
cortex
Stimulation
parameters
10Hz, 1000
pulses, 80%
MT, one
session
10Hz and
1Hz, 1000
pulses, 80%
MT, one
session
0.2Hz, 20
pulses,
100%
machine
output, one
session
Study
Design
Crossover
N
Pain etiology
Outcome
measures
Visual analog
scale
Conclusions
14
Trigeminal
neuralgia, thalamic
stroke
Crossover
18
Thalamic stroke,
brainstem lesion,
brachial plexus
lesion
Visual analog
scale
Significant but
transient reduction in
pain only after 10 Hz
rTMS
Not
reportedb
9
Brain ischemia,
spinal cord injury
or syringomyelia
Visual analog
scale, numerical
rating scale
11
Chronic migraine
Number of
migraine
attacks, number
of ingested pills
Mixed results, 3/9
patients reported
significant pain relief
for not more than 16
hours. The rTMS pain
relief was also strongly
correlated with
propofol-induced pain
relief.
Significant long-term
reduction in both
number of headaches
and amount of
medicine ingested;
effects lasted for at
20Hz, 400
pulses, 90%
MT, 12
sessions,
one every
other day
Parallel
Significant but
transient reduction in
pain
Lefaucheur
et al.
(2004)5
M1
corresponding
to the painful
area
10Hz, 1000
pulses, 80%
MT, one
session
Crossover
60
Pleger et al.
(2004)6
M1 hand area
10Hz, 120
pulses,
110% MT,
one session
Crossover
10
Khedr et al.
(2005)7
M1
corresponding
to the painful
area
Parallel
48
Crossover
5
Chronic pancreatitis Visual analog
(visceral pain)
scale
Significant but
transient reduction in
pain
Crossover
20
Poststroke, spinal
cord lesion,
trigeminal
neuropathy,
brachial plexus
injury, peripheral
neuroma operation,
Significant reduction in
pain after M1
stimulation only, as
compared with other
areas of stimulation
Fregni et al.
(2005)8
Hirayama et
al. (2006)9
20Hz, 2000
pulses, 80%
MT, five
consecutive
days
Right secondary 1Hz, 1600
somatosensory
pulses, 90%
cortex
MT, one
session
M1
5Hz, 500
corresponding
pulses, 90%
to the painful
MT, one
area and
session
somatosensory,
premotor and
supplementary
Thalamic stroke,
brainstem lesion,
brachial plexus
lesion, spinal cord
lesion, trigeminal
nerve lesion
Minor trauma,
radial fracture,
luxation of 2nd and
3rd fingers, fracture
of navicular bone
Trigeminal
neuralgia,
poststroke
Visual analog
scale
least 2 months after
treatment
Significant but
transient reduction in
pain
Visual analog
scale
Reduction in pain for
45 minutes
Visual analog
scale, LANSS
Significant reduction in
pain, up to 2 weeks
post-stimulation
Visual analog
scale, McGill
Pain
Questionnaire
area
Sampson et
al. (2006)10
Right
dorsolateral
prefrontal
cortex
AndreM1 hand area
Obadia et al. (abductor digiti
(2006)11
minimi)
cauda equina lesion
1Hz, 1600
See belowc
pulses,
110% MT, 5
times per
week for 4
weeks
1 and 20
Crossover
Hz, 1600
pulses, 90%
MT, one
session each
4
Fibromyalgia
Visual analog
scale
15–27 week reduction
in pain across all four
subjects
14
Central
supratentorial or
brainstem
poststroke pain,
spinal cord injury,
peripheral lesion
Visual analog
scale, subjective
global
assesment
Unilateral
neuropathic pain
(stroke, cervical
spinal cord lesion,
tumor, and brachial
plexus/nerve trunk
lesion)
Chronic back pain
Visual analog
scale
Pain improvement after
20 Hz and sham
stimulation, but not
after 1Hz stimulation.
Only 20Hz stimulation
predicted the efficacy
of subsequent invasive
motor cortex
stimulation
Significant reduction in
pain only after 10 Hz
rTMS
Lefaucheur
(2006)12
M1
corresponding
to the painful
hand area
10Hz and
1Hz, 1200
pulses, 90%
MT, one
session
Crossover
22
Johnson et
al. (2006)13
Left M1/S1
20Hz, 500
pulses, 95%
MT
Crossover
17
Brief Pain
Inventory
Significant reductions
in pain in 13/17
patients who received
active stimulation. The
sham condition
a
Fregni et al.
(2006)14
Left M1
(corresponding
to C3)
Fregni et al.
(2006)15
Left M1 (C3),
left dorsolateral
prefrontal
cortex (F3)
Anodal
tDCSd 20
minutes, 2
mA, five
consecutive
days
Anodal
tDCSd, 20
minutes,
2mA, five
consecutive
days
Parallel
17
Spinal cord injury
Parallel
32
Fibromyalgia
produced no significant
change in pain rating.
Visual analogue There was a significant
scale, CGI,
pain improvement after
PGA,
active anodal
medication use stimulation of the
motor cortex, but not
after sham stimulation
Visual analogue Anodal tDCS of the
scale, CGI,
primary motor cortex
PGA, SF-36®
induced significantly
Health Survey
greater pain
(Medical
improvement compared
Outcomes
with sham stimulation
Trust, Inc.,
and stimulation of the
Waltham, MA), dorsolateral prefrontal
FIQ, medication cortex. This effect was
use
still significant after 3
weeks of follow-up
All studies in this table used figure-of-eight coils. Transcranial direct current stimulation studies are shaded in gray. bStudy design specifics,
control conditions, as well as the blinds for the study were not reported. A crossover design is most likely. cPart of a double-blind shamcontrolled trial for major depression and borderline disorder; only one patient received sham stimulation. dThe reference electrode was placed
over the contralateral supraorbital area. Abbreviations: CGI, Clinical Global Impression; FIQ = Fibromyalgia Impact Questionnaire; LANSS,
Leeds assessment of neuropathic symptoms and signs; M1, primary motor cortex; MT, motor threshold; N, number of patients; PGA, patient
global assessment; rTMS, repetitive transcranial magnetic stimulation; S1, primary somatosensory cortex; tDCS; transcranial direct current
stimulation
References
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