Brain-stimulation method provides significant reductions in phantom limb pain

As many as 25,000 people a year worldwide lose limbs from land mine blasts, and a new study, published in The Journal of Pain, shows that transcranial magnetic stimulation (rTMS) administered to the scalp can stimulate the brain and provide significant reductions in phantom limb pain. The peer-reviewed Journal of Pain is published by the American Pain Society, www.americanpainsociety.org.

A team of researchers from Massachusetts General Hospital and Spaulding Rehabilitation Hospital evaluated the benefits of the brain-stimulation method in 54 patients who had amputations due to land-mine explosions. They compared results of patients given transcranial brain stimulation and a placebo treatment to determine if the procedure could provide significant relief from phantom limb pain (PLP).

PLP is a neuropathic condition manifested by pain felt as a result of a patient's enduring psychological perception of the amputated limb, and it occurs in up to 87 percent of amputation cases. "Phantom limb pain is a very challenging condition for its negative impact on quality of life and lack of treatment response, especially in those with traumatic related amputations," said co-author Ronald G. Garcia, M.D., Ph.D at Massachusetts General Hospital and Harvard Medical School.

Previous reports have suggested there are analgesic benefits of rTMS for people with PLP. In one randomized clinical trial with 27 subjects, results showed that five consecutive sessions of rTMS induced a significant analgesic effect, which lasted up to two months in 39 percent of subjects.

"In our current study, results showed that treatment with rTMS for two weeks induced a clinically significant pain reduction in 70 percent of traumatic amputees with phantom limb pain up to 15 days after treatment with no serious side effects," said Dr. Garcia.

The authors also noted the pain relief observed could be explained by the potential effect of rTMS over the central pathophysiological mechanisms related to PLP.