The proposed project will combine functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to identify neurobiological mechanisms underlying how repetitive transcranial magnetic stimulation (rTMS) applied to the primary motor cortex modulates maladaptive neuroplasticity following neuropathic pain.
Nerve conduction study: reduced compound muscle action potential (CMAP) or sensory nerve action potential (SNAP) (peroneal nerve: CMAP < 2 mV, tibial nerve: CMAP < 6.1 mV, and sural nerve: SNAP < 5 microV), or prolonged distal motor latencies (> 5.5 ms), or slowing of motor or sensory nerve conduction velocities (< 40 m/s), or prolonged minimal F latencies (> 50 ms) in two or more nerves in the lower limbs.
Quantitative sensory test: abnormal warm or cold threshold at the foot (warm/cold thresholds: > 38.6 °C /< 27.5 °C for age < 40 years, > 40.1 °C/< 26.7 °C for age 40 ~ 59 years, and > 40.6 °C/< 27.0 °C for age not less than 60 years).
Skin biopsy: reduced intraepidermal nerve fiber density at the distal leg (< 5.88 fibers/mm for age < 60 years, and < 2.50 fibers/mm for age not less than 60 years).
1. Presence of severe systemic diseases, including severe heart disease, severe lung diseases with dyspnea, severe generalized edema, systemic infection, and uncontrolled migraines due to high intracranial pressure.