2015 年 30 巻 3 号 p. 173-176
We have previously reported the efficacy of 5 Hz repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex (M1) in relief of central post–stroke pain (CPSP). The objective of this study was to explore changes of functional connectivity related to CPSP condition, and to assess changes of functional connectivity induced by rTMS in patients with CPSP. In 14 patients with CPSP and 14 control subjects, resting–state functional MRI were taken. Twelve of these patients received 5 Hz–rTMS of M1, and underwent resting–state functional MRI before and after rTMS. Functional connectivity associated with motor and default mode networks increased in patients with CPSP compared with control subjects. Moreover, functional connectivity associated with default mode network and anterior cingulate cortex decreased after rTMS. These findings suggest that several functional networks are involved in pathophysiology of CPSP and mechanisms of action of rTMS.