Therapeutic Effect Of Repetitive Transcranial Magnetic Stimulation On Neuropathic Pain After Incomplete Spinal Cord Injury

ObjectivesTo observe the clinical effect of repetitive transcranial magnetic stimulation(rTMS)on neuropathic pain after incomplete spinal cord injury(SCI).MethodsThe samples were from hospitalization patients of the rehabilitation department in the first affiliated hospital of Zhengzhou university from June 2017 to January2019 according to inclusion criteria with random number table method(24 patients in the treatment group,26 patients in the control group,1 patient withdrew from the study due to adverse reactions).They were divided into the experimental group and control group with the same comprehensive rehabilitation treatment.And the experimental group was given rTMS treatment.The control group was given pseudo-stimulation that with the same as the instrument used in rTMS plusa tilt coil to obtain ineffective treatment.Before and after treatment,simple Mc Gill pain questionnaire(includes PRI score,VAS score and PPI score)was used to assess the pain degree of patients in both groups,HAMD was used to assess the depression degree of patients,and PSQI scale was used to assess the sleep quality of patients.ResultsBefore treatment,there was no significant difference in SF-MPQ scores,HAMD scores,and PSQI scores between the two groups(P > 0.05).After 4 weeks of treatment,SF-MPQ score,HAMD score and PSQI score decreased significantly compared with those before treatment in the experimental group(P < 0.05),while VAS score,PPI score and PSQI score decreased compared with that before treatment in the control group(P < 0.05).There were no significantly difference in HAMD scores and PRI scores between before and after treatment(P > 0.05).The treatment effect of the experimental group was better than that of the control group(P <0.05).There was no significant difference in SF-MPQ scores between the two groups(P > 0.05).In the correlation factor analysis,there was no significant difference in the distribution of sex,age and course of disease in the curative effect of pain(P > 0.05),but the distribution of depression and sleep quality in the curative effect of pain was different(P < 0.05).Age,sex and course of disease are not independent factors for pain.The curative effect of depression and sleep quality are the independent factors of pain.Conclusion1.rTMS can significantly improve neuropathic pain in patients with incomplete spinal cord injury,as well as depression and sleep disorders,and is recommended for clinical application.2.The analgesic effect of rTMS is not related to the level of spinal cord injury.3.Neuropathic pain is correlated with depression and sleep disorder.