American Pain Society's 27th Annual Scientific Meeting (May 8 – 10, 2008): Cortical Stimulation for Persistent Pain Syndromes: Novel Strategies

Recent findings indicate that neuropathic pain (NP) is associated with short term and long-term neuroplastic cortical reorganization, involving changes in i) cortical representations of the affected part of the body in the somatosensory and motor cortex, and ii) cortical excitability. It has been shown that pathological changes in cortical representation correlates with pain, and reversal of these changes back to normal parallels pain relief. Moreover, patients with neuropathic pain develop hyperexcitability of the somatosensory cortex, and recent results indicate that regulation of cortical excitability in patients with neuropathic pain results in pain relief. The symposium will give a critical review of findings from TMS and tDCS studies in patients with neuropathic pain, and will discuss clinical applications of the cortical-excitability modulation in patients whose neuropathic pain poorly responds to conventional pharmacological treatment. The speakers will cover following content: 1) cortical neuroplastic changes associated with neuropathic pain (Dr.Cruciani); 2) modulation of cortical excitability in patients with neuropathic pain: a critical review of findings from TMS and tDCS studies in patients with neuropathic pain syndromes (Dr.Flor); 3) clinical potential of TMS and tDCS in pain management: pros and cons of cortical stimulation with regard to specific patient populations (Dr.Knotkova).