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J. Clin. Med. 2019, 8(4), 508; https://doi.org/10.3390/jcm8040508

Repetitive Transcranial Magnetic Stimulation Therapy (rTMS) for Endometriosis Patients with Refractory Pelvic Chronic Pain: A Pilot Study

1
Department of Gynecological Surgery, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
2
Department of Neurology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
3
Neuro-Dol, University of Clermont Auvergne, Inserm U1107, 63000 Clermont-Ferrand, France
4
Biostatistics Division (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Received: 19 March 2019 / Revised: 31 March 2019 / Accepted: 11 April 2019 / Published: 13 April 2019
(This article belongs to the Section Obstetrics & Gynecology)
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Abstract

Endometriosis concerns more than 10% of women of reproductive age, frequently leading to chronic pelvic pain. Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) induces an analgesic effect. This effect on chronic pelvic pain is yet to be evaluated. The objective of this study was to assess the feasibility and effect of rTMS to reduce pain and improve quality of life (QoL) in patients with chronic pelvic pain due to endometriosis. This pilot, open-labelled prospective trial examined treatment by neuronavigated rTMS over M1, one session per day for 5 consecutive days. Each session consisted of 1.500 pulses at 10 Hz. We assessed tolerance, pain change and QoL until 4 weeks post treatment with a primary endpoint at day 8. Twelve women were included. No patients experienced serious adverse effects or a significant increase in pain. Nine women reported improvement on the Patient Global Impression of Change with a reduction in both pain intensity and pain interference (5.1 ± 1.4 vs. 4.1 ± 1.6, p = 0.01 and 6.2 ± 2.1 vs. 4.2 ± 1.5, p = 0.004, respectively). rTMS appears well tolerated and might be of interest for patients suffering from chronic pelvic pain for whom other treatments have failed. A randomized controlled trial is mandatory before proposing such treatment. View Full-Text
Keywords: endometriosis; pain; transcranial magnetic stimulation endometriosis; pain; transcranial magnetic stimulation
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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MDPI and ACS Style

Pinot-Monange, A.; Moisset, X.; Chauvet, P.; Gremeau, A.-S.; Comptour, A.; Canis, M.; Pereira, B.; Bourdel, N. Repetitive Transcranial Magnetic Stimulation Therapy (rTMS) for Endometriosis Patients with Refractory Pelvic Chronic Pain: A Pilot Study. J. Clin. Med. 2019, 8, 508.

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