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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References
- A Meta-Analytic Review of Stand-Alone Interventions to Improve Body Image.PLoS One. 2015; 10e0139177
- Somatosensory processing and body representation.Cortex. 2009; 45: 1078-1084
- Rapid cortical reorganization and improved sensitivity of the hand following cutaneous anesthesia of the forearm.The European journal of neuroscience. 2009; 29: 837-844
- Secondary somatosensory cortex of primates: beyond body maps, toward conscious self-in-the-world maps.Exp Brain Res. 2020; 238: 259-272
- Chairside intraoral qualitative somatosensory testing: reliability and comparison between patients with atypical odontalgia and healthy controls.Journal of orofacial pain. 2013; 27: 165-170
- Use of theta-burst stimulation in changing excitability of motor cortex: A systematic review and meta-analysis.Neurosci Biobehav Rev. 2016; 63: 43-64
- Multisensory modulation of experimentally evoked perceptual distortion of the face.Journal of oral rehabilitation. 2018; 45: 1-8
- Experimental orofacial pain and sensory deprivation lead to perceptual distortion of the face in healthy volunteers.Experimental brain research. 2015; 233: 2597-2606
- Reports of perceptual distortion of the face are common in patients with different types of chronic oro-facial pain.Journal of oral rehabilitation. 2016; 43: 409-416
- Perceptual distortions of the human body image produced by local anesthesia, pain and cutaneous stimulation.The Journal of physiology. 1999; 514: 609-616
- Somatosensory cortical representation of the body size.Human brain mapping. 2019; 40: 3534-3547
- The relationship of perceptual phenomena and cortical reorganization in upper extremity amputees.Neuroscience. 2001; 102: 263-272
- Influence of Repetitive Transcranial Magnetic Stimulation on Human Neurochemistry and Functional Connectivity: A Pilot MRI/MRS Study at 7 T.Frontiers in neuroscience. 2019; 13: 1260
- Repetitive Transcranial Magnetic Stimulation on Motor Recovery for Patients With Stroke: A PRISMA Compliant Systematic Review and Meta-analysis.Am J Phys Med Rehabil. 2020; 99: 99-108
- Reduction of intractable deafferentation pain by navigation-guided repetitive transcranial magnetic stimulation of the primary motor cortex.Pain. 2006; 122: 22-27
- Body Image Distortion.StatPearls, StatPearls Publishing Copyright © 2020. StatPearls Publishing LLC., Treasure Island (FL)2020
- Theta burst stimulation of the human motor cortex.Neuron. 2005; 45: 201-206
- The theoretical model of theta burst form of repetitive transcranial magnetic stimulation.Clin Neurophysiol. 2011; 122: 1011-1018
- Distorted body image influences body schema in individuals with negative bodily attitudes.Neuropsychologia. 2019; 122: 38-50
- Non-painful phantom limb phenomena in amputees: incidence, clinical characteristics and temporal course.Acta Neurologica Scandinavica. 1984; 70: 407-414
- Modulation of somatosensory evoked potentials using transcranial magnetic intermittent theta burst stimulation.Clin Neurophysiol. 2007; 118: 2506-2511
- Effect of repetitive transcranial magnetic stimulation on altered perception of One's own face.Brain stimulation. 2020; 13: 554-561
- Quantitative and qualitative assessment of sensory changes induced by local anesthetics block of two different trigeminal nerve branches.Clin Oral Investig. 2019; 23: 2637-2649
- Analgesic effects of repetitive transcranial magnetic stimulation of the motor cortex in neuropathic pain: influence of theta burst stimulation priming.Eur J Pain. 2012; 16: 1403-1413
- Rapid modulation of GABA in sensorimotor cortex induced by acute deafferentation.Annals of Neurology. 2002; 52: 755-761
- Body perception disturbance: a contribution to pain in complex regional pain syndrome (CRPS).Pain. 2007; 133: 111-119
- More than skin deep: body representation beyond primary somatosensory cortex.Neuropsychologia. 2010; 48: 655-668
- A supramodal representation of the body surface.Neuropsychologia. 2011; 49: 1194-1201
- Continuous theta-burst stimulation demonstrates a causal role of premotor homunculus in action understanding.Psychological science. 2014; 25: 963-972
- The structural and functional connectivity neural underpinnings of body image.Human brain mapping. 2021; 42: 3608-3619
- A model-driven approach to studying dissociations between body size mental representations in anorexia nervosa.Body image. 2017; 20: 40-48
- I can't find it! Distorted body image and tactile dysfunction in patients with chronic back pain.Pain. 2008; 140: 239-243
- Cognitive outcomes of TMS treatment in bipolar depression: Safety data from a randomized controlled trial.J Affect Disord. 2018; 235: 20-26
- Dose-dependent effects of theta burst rTMS on cortical excitability and resting-state connectivity of the human motor system.J Neurosci. 2014; 34: 6849-6859
- Short-term brain 'plasticity' in humans: transient finger representation changes in sensory cortex somatotopy following ischemic anesthesia.Brain research. 1994; 642: 169-177
- Temporary interference in human lateral premotor cortex suggests dominance for the selection of movements. A study using transcranial magnetic stimulation.Brain : a journal of neurology. 1998; 121: 785-799
- Painful stimulation and transient blocking of nerve transduction due to local anesthesia evoke perceptual distortions of the face in healthy volunteers.The journal of pain : official journal of the American Pain Society. 2015; 16: 335-345
- Efficacy and Time Course of Theta Burst Stimulation in Healthy Humans.Brain stimulation. 2015; 8: 685-692
- The After-Effect of Accelerated Intermittent Theta Burst Stimulation at Different Session Intervals.Frontiers in neuroscience. 2020; 14: 576
Article info
Publication history
Published online: January 14, 2022
Accepted:
December 27,
2021
Received in revised form:
December 10,
2021
Received:
September 8,
2021
Footnotes
Declaration of Competing Interest: None of the authors has any conflicts of interests
Funding: This study was funded by Det Frie Forskningsråd, Danish Council for Independent Research with grant reference number 6110-00156.
Identification
Copyright
© 2022 by United States Association for the Study of Pain, Inc.