Non-invasive brain stimulation (NIBS) is increasingly proposed as a therapeutic intervention for many neurological and psychiatric disorders, including pain, depression, obsessive compulsive disorder, and anxiety. While neuromodulation as an intervention for pain relief has a well-established scientific basis, evidence is largely restricted to invasive stimulation that targets the spinal cord. Novel non-invasive methodologies instead predominately target cortical processing of pain and thus raise interesting questions about how the most effective pain relief can be achieved. Functional magnetic resonance imaging (fMRI) studies show a widespread and distributed activation of brain areas during pain. This diverse activity is often referred to as the “pain neuromatrix” and can lead to the proposal for different possible target areas for pain relief. Neuromodulation could target brain regions of pain processing areas responsible for sensorimotor processing or alternatively regions responsible for the affective and evaluative aspects of the subjective pain experience. The chapter addresses the different approaches currently taken in the use of non-invasive neuromodulation for altering pain both in an experimental setting and the challenges involved in the translation of these techniques to a diverse range of chronic pain conditions.
Part of the book: Transcranial Magnetic Stimulation in Neuropsychiatry