Effects of deep, shaped magnetic field pulses on acute and chronic pain
Monday, Oct 15, 2012, 4:00 PM - 5:00 PM
*A. Z. TZABAZIS
, D. C. YEOMANS
, C. MARI APARICI
, H. VANBROCKLIN
, Y. SEO
, A. ETKIN
, L. TABER
, S. YANG
, M. SCHNEIDER
Dept. of Anesthesia, Eggolsheim, Germany;
Psychiatry and Behavioral Sci.,
Stanford Univ., Stanford, CA;
Radiology, Univ. of San Francisco, San Francisco, CA;
Premier Res. Group, Phoenix, AZ;
Cervel Neurotech Inc, San Mateo, CA;
Cervel Neurotech Inc., San Mateo, CA
Pain is a silent epidemic, demonstrating the failure of current treatments to adequately address many clinical pain states. These limitations are demonstrative of the need for new paradigms. The work described here addresses this need by aiming to develop a completely novel, non-pharmaceutical, non-invasive approach to pain treatment using shaped magnetic field pulses to induce analgesia by preferentially targeting deep brain areas that are critical in pain perception, including the anterior cingulate cortex. We used 4 custom arrays of rTMS electromagnetic coils (Cervel Neurotech) to produce reconfigurably-shaped magnetic fields aimed upon the anterior cingulate cortex. In a volunteer study, 19 subjects were subjected to 15O-H2O positron emission tomography (PET) functional brain imaging and minute-by-minute pain assessment during a ten-minute thermal pain stimulus using an 11-point numeric rating scale (NRS). Pulsed magnetic fields applied at 1 Hz with a particular coil array produced both a clear attenuation of PET-imaged activation of the anterior cingulate as well as an average maximal pain decrease of 79%. Attenuation of anterior cingulate activation was significantly correlated with effect on evoked pain. Other configurations were less effective or proalgesic, with one configuration enhancing pain scores by 32%.
Given these promising results, we tested the effect of shaped magnetic field pulses on 45 patients (aged 18-65) diagnosed with fibromyalgia with a baseline pain score of > 4. Each subject received 20 magnetic field pulse sessions on consecutive weekdays. Subjects treated with the same 4-coil, 10 Hz configuration (N = 5) used in the volunteer study, but pulsed at 10, rather than 1 HZ, significantly improved, with mean reduction in pain scores of 43% which was maintained for at least 4 weeks. Improvement in each of the other 2 active treatment arms (1 Hz, 4-coil array, n=17; 10 Hz, 2-coil array, n = 4) did not exceed that of the sham group (n = 19). Furthermore, calculated magnetic field power applied to the anterior cingulate was significantly correlated to analgesic effect. These data suggest that deep-brain magnetic field pulses can be effective non-pharmacologic treatments for both acute and chronic pain.
Consultant/Advisory Board; Alexander Tzabazis.
Consultant/Advisory Board; David Yeomans.
C. Mari Aparici:
Consultant/Advisory Board; Carina Mari Aparice.
Consultant/Advisory Board; Henry VanBrocklin.
Other Research Support; Louise Taber.
Employment; Stephanie Yang.
Consultant/Advisory Board; M. Bret Schneider.
DEEP BRAIN STIMULATION
[Authors]. [Abstract Title]. Program No. XXX.XX. 2012 Neuroscience Meeting Planner. New Orleans, LA: Society for Neuroscience, 2012. Online.
2012 Copyright by the Society for Neuroscience all rights reserved. Permission to republish any abstract or part of any abstract in any form must be obtained in writing by SfN office prior to publication.
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