Transspinal Magnetic Stimulation for the Treatment of Neuropathic Pain

ABSTRACT.
Chronic pain ranks among the top reasons for seeking medical attention. Spinal Cord Stimulation (SCS) has
been a traditional approach for managing chronic neuropathic pain in the back and legs. This method, however,
involves an invasive procedure that requires the patient to live with an implant. In contrast, Low-Intensity Focused
Ultrasound (LIFU) presents a non-invasive alternative explored in clinical trials for modifying central nervous
system activity, promising quicker neuromodulation for pain relief. Our research shows that a brief, three-minute
LIFU treatment targeting the dorsal root ganglion (DRG) can suppress pain responses in small and large animal
models for extended periods. Yet, targeting other crucial spinal areas for pain management, like the dorsal
columns, remains a challenge due to anatomical constraints.
Building on the development of an advanced miniaturized Transcranial Stimulation (TMS) system, our project
aims to create a groundbreaking High Frequency (HF) Trans-Spinal Magnetic Stimulation (TSMS) tool. This new
system draws upon previous successes in dorsal column stimulation research and numerical simulations, setting
the stage for the first non-invasive dorsal spinal cord stimulation to address back pain. Utilizing a novel 10kHz
magnetic pulse, the HF-TSMS system mirrors the frequency used in invasive SCS treatments, which have been
effective in managing sciatica and significantly reducing opioid use among patients.
We aim to refine HF-TSMS to target neural pathways involved in neuropathic back and leg pain. To achieve
this, we plan to conduct experimental studies using rodent models at Massachusetts General Hospital, assessing
pain responses via fMRI. Further efficacy and safety evaluations will be conducted in larger animal models at
the University of Arizona. Following these studies, we aim to secure an Investigational Device Exemption (IDE)
and initiate a preclinical pilot trial in humans suffering from neuropathic pain. The introduction of HF-TSMS as a
non-invasive, drug-free treatment option could significantly impact the management of chronic neuropathic pain,
offering new hope for patients with sciatica.

Grant Number: 1R18EB036591-01
NIH Institute/Center: NIH
Principal Investigator: GIORGIO BONMASSAR