Analgesic effects of non-invasive cortical stimulations by repetitive transcranial magnetic stimulation (rTMS)

The non-invasive brain stimulation by Repetitive Transcranial Magnetic Stimulation (rTMS) is increasingly used in clinical practice as a possible treatment of chronic neuropathic pain. After an introduction on the neuropathic pain and the technique of neuromodulation, I first report our clinical experience on more than 1000 neuronavigated rTMS sessions over the primary motor cortex (M1): description of the analgesic effect, paradigms of stimulation and long-term effects. Then, I will show how we used these results to build a controlled cross-over study in order to assess our new protocol. This prospective protocol is still in progress and we will speak about the interim analysis and first results. In a third part, I will address my research in progress: stimulation of a new target, the secondary somatosensory cortex (S2), and the mapping work in collaboration with the engineering school of Telecom at Saint-Etienne.