Non-invasive TMS attenuates neuropathic pain after spinal cord injury associated with enhancing brain functional connectivity and HPA axis activity

Spinal cord injury (SCI) often leads to neuropathic pain. Transcranial magnetic stimulation (TMS) has shown promise in alleviating this pain, but the precise strategies and mechanisms by which TMS affects brain function post-SCI remain unclear. This study investigates how TMS impacts neuropathic pain in mice after SCI. The research explores how TMS affects brain and spinal cord function using various techniques, including functional magnetic resonance imaging (fMRI) and RNA sequencing. The findings reveal that early TMS intervention can improve neuropathic pain by enhancing brain connectivity, activating the hypothalamic-pituitary-adrenal (HPA) axis, and reducing inflammation in the spinal cord, offering potential therapeutic strategies for managing neuropathic pain post-SCI.

• 1
  TMS significantly improved SCI induced mechanical allodynia, cold and thermal hyperalgesia with a durative effect, and TMS intervention at 1 week after SCI had pain relief advantages than at 2 weeks.
• 2
  TMS intervention not only affected the functional connections between the primary motor cortex and the thalamus, but also increased the close connection of multiple brain regions.
• 3
  TMS treatment activated the hypothalamic pituitary adrenal (HPA) axis and increased the transcript levels of genes encode hormone proteins, accompanied with the attenuation of inflammatory microenvironment in spinal cord associated with pain relief.