La neurostimulation cérébrale non invasive dans les douleurs neuropathiques

Epidural motor cortex stimulation (MCS) has proven to be effective for pain relief in around 60% of patients suffering from chronic neuropathic pain refractory to pharmacological analgesics. Common to all surgeries, this procedure is not without risk. The aim of these non-invasive stimulation techniques is to obtain the same efficacy avoiding surgery. Repetitive transcranial magnetic stimulation (rTMS) has an action mode similar to MCS. Targeting either primary motor cortex or dorsolateral prefrontal cortex, it is possible to obtain an analgesic effect that can last for more than 2 weeks after each session. Concerning transcranial direct current stimulation (tDCS), the action mechanism is quite different as it is based on the modulation of axon potential in a large part of the brain. The aim of this short article is to provide some data concerning efficacy and ways toward amelioration of these two techniques.