Effect of repetitive transcranial magnetic stimulation on altered perception of One’s own face

Background: Chronic orofacial pain (COP) patients often perceive the painful face area as “swollen” without clinical signs; such self-reported illusions of the face are termed perceptual distortion (PD). The pathophysiological mechanisms underlying PD remain elusive. Objective: To test the neuromodu...

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Main Authors: Simple Futarmal Kothari, Lilja Kristin Dagsdóttir, Mohit Kothari, Jakob Udby Blicher, Abhishek Kumar, Poul Erik Buchholtz, Mahmoud Ashkanian, Peter Svensson
Format: Article
Language:English
Published: Elsevier 2020-05-01
Series:Brain Stimulation
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1935861X20300012
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spelling doaj-a12d67087e6c45d2889e718fdb9d92a62021-03-19T07:21:29ZengElsevierBrain Stimulation1935-861X2020-05-01133554561Effect of repetitive transcranial magnetic stimulation on altered perception of One’s own faceSimple Futarmal Kothari0Lilja Kristin Dagsdóttir1Mohit Kothari2Jakob Udby Blicher3Abhishek Kumar4Poul Erik Buchholtz5Mahmoud Ashkanian6Peter Svensson7Department of Dentistry and Oral Health, Aarhus University, Aarhus C, 8000, Denmark; Scandinavian Center for Orofacial Neurosciences (SCON), Denmark; Hammel Neurorehabilitation and University Research Clinic, Hammel, 8450, Denmark; Corresponding author. Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, DenmarkDepartment of Dentistry and Oral Health, Aarhus University, Aarhus C, 8000, Denmark; Scandinavian Center for Orofacial Neurosciences (SCON), DenmarkDepartment of Clinical Medicine, Aarhus University, Aarhus N, 8200, Denmark; Hammel Neurorehabilitation and University Research Clinic, Hammel, 8450, DenmarkCFIN, Department of Clinical Medicine, Aarhus University, Aarhus N, 8200, DenmarkScandinavian Center for Orofacial Neurosciences (SCON), Denmark; Department of Dental Medicine, Karolinska Institutet, Huddinge, 141 04, SwedenDepartment for Depression and Anxiety Disorders, Aarhus University Hospital, Aarhus N, 8200, DenmarkDepartment for Depression and Anxiety Disorders, Aarhus University Hospital, Aarhus N, 8200, DenmarkDepartment of Dentistry and Oral Health, Aarhus University, Aarhus C, 8000, Denmark; Scandinavian Center for Orofacial Neurosciences (SCON), Denmark; Faculty of Odontology, Malmø University, SwedenBackground: Chronic orofacial pain (COP) patients often perceive the painful face area as “swollen” without clinical signs; such self-reported illusions of the face are termed perceptual distortion (PD). The pathophysiological mechanisms underlying PD remain elusive. Objective: To test the neuromodulatory effect of repetitive transcranial magnetic stimulation (rTMS) on PD in healthy individuals, to gain insight into the cortical mechanisms underlying PD. Methods: PD was induced experimentally by injections of local anesthetic (LA) around the infraorbital nerve and measured as perceived size changes of the affected area. Participants were randomly allocated to inhibitory rTMS (n = 26) or sham rTMS (n = 26) group. The participants rated PD at baseline, 6 min after LA, immediately, 20 and 40 min after rTMS. The rTMS (inhibitory and sham) was applied to face (lip) representation area of primary somatosensory cortex (SI) as an intervention at 10 min after the LA, when the magnitude of PD is large. As inhibitory rTMS, continuous theta-burst stimulation paradigm (50 Hz) for 40s was employed to inhibit cortical activity. Results: We demonstrated a significant decrease in the magnitude of PD immediately and 20 min after the application of inhibitory rTMS compared with sham rTMS (P < 0.006). In two control experiments, we also showed that peripheral muscle stimulation and stimulation of a cortical region other than the lip representation area had no effect on the magnitude of the PD. Conclusions: Inhibitory rTMS applied to a somatotopical-relevant cortical region modulates PD of the face in healthy individuals and could potentially have therapeutic implications for COP patients.http://www.sciencedirect.com/science/article/pii/S1935861X20300012Perceptual distortion of faceRepetitive transcranial magnetic stimulationLocal anesthesiaTheta-burst stimulationOrofacial painPrimary somatosensory cortex
collection DOAJ
language English
format Article
sources DOAJ
author Simple Futarmal Kothari
Lilja Kristin Dagsdóttir
Mohit Kothari
Jakob Udby Blicher
Abhishek Kumar
Poul Erik Buchholtz
Mahmoud Ashkanian
Peter Svensson
spellingShingle Simple Futarmal Kothari
Lilja Kristin Dagsdóttir
Mohit Kothari
Jakob Udby Blicher
Abhishek Kumar
Poul Erik Buchholtz
Mahmoud Ashkanian
Peter Svensson
Effect of repetitive transcranial magnetic stimulation on altered perception of One’s own face
Brain Stimulation
Perceptual distortion of face
Repetitive transcranial magnetic stimulation
Local anesthesia
Theta-burst stimulation
Orofacial pain
Primary somatosensory cortex
author_facet Simple Futarmal Kothari
Lilja Kristin Dagsdóttir
Mohit Kothari
Jakob Udby Blicher
Abhishek Kumar
Poul Erik Buchholtz
Mahmoud Ashkanian
Peter Svensson
author_sort Simple Futarmal Kothari
title Effect of repetitive transcranial magnetic stimulation on altered perception of One’s own face
title_short Effect of repetitive transcranial magnetic stimulation on altered perception of One’s own face
title_full Effect of repetitive transcranial magnetic stimulation on altered perception of One’s own face
title_fullStr Effect of repetitive transcranial magnetic stimulation on altered perception of One’s own face
title_full_unstemmed Effect of repetitive transcranial magnetic stimulation on altered perception of One’s own face
title_sort effect of repetitive transcranial magnetic stimulation on altered perception of one’s own face
publisher Elsevier
series Brain Stimulation
issn 1935-861X
publishDate 2020-05-01
description Background: Chronic orofacial pain (COP) patients often perceive the painful face area as “swollen” without clinical signs; such self-reported illusions of the face are termed perceptual distortion (PD). The pathophysiological mechanisms underlying PD remain elusive. Objective: To test the neuromodulatory effect of repetitive transcranial magnetic stimulation (rTMS) on PD in healthy individuals, to gain insight into the cortical mechanisms underlying PD. Methods: PD was induced experimentally by injections of local anesthetic (LA) around the infraorbital nerve and measured as perceived size changes of the affected area. Participants were randomly allocated to inhibitory rTMS (n = 26) or sham rTMS (n = 26) group. The participants rated PD at baseline, 6 min after LA, immediately, 20 and 40 min after rTMS. The rTMS (inhibitory and sham) was applied to face (lip) representation area of primary somatosensory cortex (SI) as an intervention at 10 min after the LA, when the magnitude of PD is large. As inhibitory rTMS, continuous theta-burst stimulation paradigm (50 Hz) for 40s was employed to inhibit cortical activity. Results: We demonstrated a significant decrease in the magnitude of PD immediately and 20 min after the application of inhibitory rTMS compared with sham rTMS (P < 0.006). In two control experiments, we also showed that peripheral muscle stimulation and stimulation of a cortical region other than the lip representation area had no effect on the magnitude of the PD. Conclusions: Inhibitory rTMS applied to a somatotopical-relevant cortical region modulates PD of the face in healthy individuals and could potentially have therapeutic implications for COP patients.
topic Perceptual distortion of face
Repetitive transcranial magnetic stimulation
Local anesthesia
Theta-burst stimulation
Orofacial pain
Primary somatosensory cortex
url http://www.sciencedirect.com/science/article/pii/S1935861X20300012
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