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Facilitatory Effect of Intermittent Repetitive Transcranial Magnetic Stimulation on Perceptual Distortion of the Face

  • Simple Futarmal Kothari
    Correspondence
    Address reprint requests to Simple Futarmal Kothari, BDS, MSc, PhD, Postdoctoral Fellow, Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark.
    Affiliations
    Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark

    Scandinavian Center for Orofacial Neurosciences (SCON)

    Hammel Neurorehabilitation Center and University Research Clinic, Aarhus University, Hammel, Denmark
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  • Jakob U. Blicher
    Affiliations
    CFIN, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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  • Lilja K. Dagsdottir
    Affiliations
    Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark

    Scandinavian Center for Orofacial Neurosciences (SCON)
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  • Mohit Kothari
    Affiliations
    Hammel Neurorehabilitation Center and University Research Clinic, Aarhus University, Hammel, Denmark

    JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, India
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  • Abhishek Kumar
    Affiliations
    Scandinavian Center for Orofacial Neurosciences (SCON)

    Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
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  • Kaushik Sengupta
    Affiliations
    Department of Public Health, University of Copenhagen, Copenhagen, Denmark

    Larix A/S, Herlev, Denmark
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  • Poul E. Buchholtz
    Affiliations
    Department for Depression and Anxiety Disorders, Aarhus University Hospital, Aarhus, Denmark
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  • Mahmoud Ashkanian
    Affiliations
    Department for Depression and Anxiety Disorders, Aarhus University Hospital, Aarhus, Denmark
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  • Peter Svensson
    Affiliations
    Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark

    Scandinavian Center for Orofacial Neurosciences (SCON)

    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmӧ University, Malmӧ, Sweden
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Published:January 14, 2022DOI:https://doi.org/10.1016/j.jpain.2021.12.013

      Highlights

      • Neuromodulatory effect of iTBS on facial perception is assessed.
      • iTBS produced facilitatory effect on facial perceptual distortion.
      • Magnitude of perceived size changes in the face region increased on iTBS of face SI.
      • Face SI is involved in the processing of facial perceptual distortion.

      Abstract

      Orofacial pain patients often report that the painful facial area is “swollen” without clinical signs - known as perceptual distortion (PD). The neuromodulatory effect of facilitatory repetitive transcranial magnetic stimulation (rTMS) on PD in healthy individuals was investigated, to provide further support that the primary somatosensory cortex (SI) is involved in facial PD. Participants were allocated to active (n = 26) or sham (n = 26) rTMS group in this case-control study. PD was induced experimentally by injecting local anesthesia (LA) in the right infraorbital region. PD was measured at baseline, 6 min after LA, immediately, 20 and 40 min after rTMS. Intermittent theta-burst stimulation (iTBS) as active rTMS and sham rTMS was applied to the face representation area of SI at 10 min after LA. The magnitude of PD was compared between the groups. The magnitude of PD significantly increased immediately after iTBS compared with sham rTMS (P = .009). The PD was significantly higher immediately after iTBS compared to 6 min after LA (P = .004) in the active rTMS group, but not in the sham rTMS group (P = .054). iTBS applied to a somatotopic-relevant cortical region appears to facilitate facial PD further supporting the involvement of SI in the processing of one´s own face and PD.

      Perspective

      This study provides information on neural substrate responsible for processing of perceptual distortion of the face which is speculated to contribute to the chronification of orofacial pain. The findings of this study may aid in mechanism-based management of the condition in orofacial pain disorders and possibly other chronic pain states.

      Keywords

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