Non-invasive Brain Stimulation: Challenges and Directions for Future Pain Studies

October 2013

The medical field mostly relies on chemicals (e.g., medications) to treat illness, but since neurons use electrical signaling, some neurological disorders can be treated electrically. The advantage is that electrical current only affects nearby cells, unlike drugs that can spread through the body to cause adverse effects elsewhere. The disadvantage has been that major surgery is needed to insert the stimulating electrodes. However, the brain’s cortical neurons can now be activated externally by non-invasive brain stimulation techniques such as holding electromagnetic coils to the scalp. Repetitive transcranial magnetic stimulation (rTMS) is FDA-approved and marketed for major depression, but it is not yet considered proven, nor is it consensus recommended for pain despite several trials reporting efficacy for neuropathic (nerve injury) pain. There are substantial difficulties with design, performance, and analysis of device trials, and international collaboration is necessary to coalesce the field around consensus standards. The seminar assembles leaders in their fields whose collective experience will advance this initiative.