S1-4. The effect of repetitive Transcranial Magnetic Stimulation (rTMS) in patients with intractable cervical dystonia and/or post-stroke central pain

Non-invasive rTMS has been recently used in the evaluation of various neurological disorders. The aim of this study is to clarify the therapeutic effects of rTMS in patients with intractable cervical dystonia (CD) and/or central post-stroke pain (CPSP). In 6 patients with CD, low-frequency rTMS (0.2 Hz) was applied to the frontal area (including pre-motor cortex), 100 times per session once a week for 6 months. Only single session reduced the muscle pain for 4–7 days. Reduction of Pain Scale and Severity Scale of Toronto Western Spasmodic Torticollis Rating Scale was observed among 2 months’ session. Not only abnormal postures but also repetitive movements were reduced among 6 months’ session. In 8 patients with CPSP, high-frequency rTMS (10 Hz) was applied to the primary motor cortex, 500 times per session among every 3 days. The pain was dramatically reduced by single session alone. But, the effect on spontaneous pain is limited in all sessions. The improvement on affective component of the McGill Pain Questionnaire (MPQ) was better than the other component of MPQ in all sessions. In conclusion, rTMS is useful as one of the option in the treatment of intractable CD and CPSP.