Time-Course of Pain Threshold After Continuous Theta Burst Stimulation of Primary Somatosensory Cortex in Pain-Free Subjects


Neuroscience Letters. 722:134760, 2020 03 23.

Rao N; Chen YT; Ramirez R; Tran J; Li S; Parikh PJ

Primary somatosensory cortex (S1) is involved in pain processing and thus its suppression using neuromodulatory techniques such as continuous theta burst stimulation (cTBS) might be a potential pain management strategy in patients with neuropathic pain. cTBS over S1 is known to elevate pain threshold in young adults. However, the time course of this after-effect is unknown. Furthermore, the effect of cTBS over S1 on pain threshold might be confounded by changes in the excitability of primary motor cortex (M1), an area known to be involved in pain processing, due to spread of current. Therefore, whether S1 plays a role in pain processing independent of M1 also remains unknown. The corticospinal excitability (CSE) can provide a measure of M1 excitability because cTBS over M1 is known to reduce CSE. Here, we studied the time-course of the effects of MRI-guided cTBS over S1 on electrical pain threshold (EPT) and CSE. Ten healthy young adults received cTBS over S1 and sham stimulation in counterbalanced sessions at least 5 days apart. EPT and CSE were recorded before and following cTBS over S1. We assessed each measure once before stimulation and then every 10min starting immediately after stimulation until 40min. cTBS over S1 elevated EPT compared to sham stimulation with the after-effect lasting for 40min. We observed no change in CSE following cTBS and sham stimulation. Our findings suggest that cTBS over S1 can elevate EPT for 40min without altering M1 excitability.