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rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring

INTRODUCTION: Chronic pain associates with various sleep problems. Patients with complex regional pain syndrome (CRPS) often report impaired sleep, but objective measurements of sleep in CRPS patients are scarce. Neuromodulation with repetitive transcranial magnetic stimulation (rTMS) can alleviate...

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Autores principales: Vanhanen, Jukka, Kujala, Jan, Liljeström, Mia, Kalso, Eija, Virkkala, Jussi, Harno, Hanna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636402/
https://www.ncbi.nlm.nih.gov/pubmed/37700567
http://dx.doi.org/10.1002/brb3.3252
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author Vanhanen, Jukka
Kujala, Jan
Liljeström, Mia
Kalso, Eija
Virkkala, Jussi
Harno, Hanna
author_facet Vanhanen, Jukka
Kujala, Jan
Liljeström, Mia
Kalso, Eija
Virkkala, Jussi
Harno, Hanna
author_sort Vanhanen, Jukka
collection PubMed
description INTRODUCTION: Chronic pain associates with various sleep problems. Patients with complex regional pain syndrome (CRPS) often report impaired sleep, but objective measurements of sleep in CRPS patients are scarce. Neuromodulation with repetitive transcranial magnetic stimulation (rTMS) can alleviate pain and improve sleep. Secondary somatosensory cortex (S2) is a possible rTMS target for the treatment of chronic pain, but the effect of S2‐targeted rTMS on sleep is unknown. METHODS: This randomized, sham‐controlled trial assessed the effect of S2‐targeted rTMS on sleep in patients with CRPS. Patients (n = 31) received either S2‐targeted rTMS (10 Hz) or sham stimulation for 3 weeks. The effect of treatment on sleep was assessed with validated questionnaires, with a sleep and pain diary, and with a consumer‐grade sleep tracker, the Oura ring. In addition to an ordinary univariate analysis of the results, we conducted multivariate testing of the Oura data using linear discriminant analysis (LDA). RESULTS: S2‐targeted rTMS decreased sleep restlessness that significantly differed between the rTMS and sham stimulation patient groups (p = .028). In the multivariate analysis of the Oura data, LDA classification accuracy to separate the rTMS and sham groups exceeded 95% confidence level in four out of the seven tested models. In the subjective evaluation of sleep, the effect of rTMS and sham did not differ. CONCLUSION: S2‐targeted rTMS influenced sleep in patients with CRPS. Improved sleep may enhance CRPS symptom alleviation and be of clinical importance. A univariate analysis could separate the rTMS and sham treatments. The multivariate analysis revealed that including multiple sleep‐related parameters can be beneficial when analyzing rTMS effects on sleep. As sleep is related both to pain and quality of life, and sleep rTMS can be directly affected by rTMS, objective monitoring of sleep in various future rTMS trials could be fruitful.
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spelling pubmed-106364022023-11-15 rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring Vanhanen, Jukka Kujala, Jan Liljeström, Mia Kalso, Eija Virkkala, Jussi Harno, Hanna Brain Behav Original Articles INTRODUCTION: Chronic pain associates with various sleep problems. Patients with complex regional pain syndrome (CRPS) often report impaired sleep, but objective measurements of sleep in CRPS patients are scarce. Neuromodulation with repetitive transcranial magnetic stimulation (rTMS) can alleviate pain and improve sleep. Secondary somatosensory cortex (S2) is a possible rTMS target for the treatment of chronic pain, but the effect of S2‐targeted rTMS on sleep is unknown. METHODS: This randomized, sham‐controlled trial assessed the effect of S2‐targeted rTMS on sleep in patients with CRPS. Patients (n = 31) received either S2‐targeted rTMS (10 Hz) or sham stimulation for 3 weeks. The effect of treatment on sleep was assessed with validated questionnaires, with a sleep and pain diary, and with a consumer‐grade sleep tracker, the Oura ring. In addition to an ordinary univariate analysis of the results, we conducted multivariate testing of the Oura data using linear discriminant analysis (LDA). RESULTS: S2‐targeted rTMS decreased sleep restlessness that significantly differed between the rTMS and sham stimulation patient groups (p = .028). In the multivariate analysis of the Oura data, LDA classification accuracy to separate the rTMS and sham groups exceeded 95% confidence level in four out of the seven tested models. In the subjective evaluation of sleep, the effect of rTMS and sham did not differ. CONCLUSION: S2‐targeted rTMS influenced sleep in patients with CRPS. Improved sleep may enhance CRPS symptom alleviation and be of clinical importance. A univariate analysis could separate the rTMS and sham treatments. The multivariate analysis revealed that including multiple sleep‐related parameters can be beneficial when analyzing rTMS effects on sleep. As sleep is related both to pain and quality of life, and sleep rTMS can be directly affected by rTMS, objective monitoring of sleep in various future rTMS trials could be fruitful. John Wiley and Sons Inc. 2023-09-12 /pmc/articles/PMC10636402/ /pubmed/37700567 http://dx.doi.org/10.1002/brb3.3252 Text en © 2023 The Authors. Brain and Behavior published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Vanhanen, Jukka
Kujala, Jan
Liljeström, Mia
Kalso, Eija
Virkkala, Jussi
Harno, Hanna
rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring
title rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring
title_full rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring
title_fullStr rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring
title_full_unstemmed rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring
title_short rTMS targeted to the secondary somatosensory cortex influences sleep in CRPS patients, as measured with the OURA ring
title_sort rtms targeted to the secondary somatosensory cortex influences sleep in crps patients, as measured with the oura ring
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10636402/
https://www.ncbi.nlm.nih.gov/pubmed/37700567
http://dx.doi.org/10.1002/brb3.3252
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