Transcranial Magnetic Stimulation Measures of Corticospinal Excitability in Black and Hispanic/Latino People with Painful Peripheral Neuropathy

Abstract

This study aims to provide preliminary descriptive data on transcranial magnetic stimulation (TMS) measures obtained in Black and Hispanic/Latino individuals with chronic painful peripheral neuropathy (PN), including those with chemotherapy-induced peripheral neuropathy (CIPN) and diabetic neuropathy (DN). CIPN and DN share similar neuropathic symptoms and underlying physiological mechanisms, in particular altered central nervous system processing. TMS is a non-invasive technique that can assess corticospinal excitability and the function of GABAergic and glutamatergic pathways, potentially serving as a diagnostic tool for PN. This secondary analysis utilized data from a pilot randomized sham-controlled trial of transcutaneous auricular vagus nerve stimulation (taVNS) in people with PN. TMS measures, including resting motor threshold (RMT), unconditioned MEP amplitude (spTMS), short interval intracortical inhibition (SICI), and intracortical facilitation (ICF), were assessed at baseline over 2 separate visits. Test-retest reliability was evaluated, and changes in TMS measures following transcutaneous auricular vagus nerve stimulation were analyzed. Baseline TMS measures showed no significant differences between CIPN and DN groups. The study found good test-retest reliability for TMS measures, with ICC values between 0.73 and 0.87 for all TMS measures. Post taVNS, neuropathic pain symptoms improved, with a slight decrease in ICF. Overall, TMS measures demonstrated good reliability in this sample of Black and Hispanic/Latino individuals with PN, and these findings provide valuable preliminary data for future studies aimed at establishing the psychometric properties and diagnostic utility of TMS measures in PN.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

NCT05896202

Funding Statement

This project was supported by the National Institutes of Health National Center of Neuromodulation for Rehabilitation (NIH/NICHD Grant Number P2CHD086844). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH or NICHD.

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I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee/IRB of the University of Miami gave ethical approval for this work.

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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Data Availability

All data produced in the present study are available upon reasonable request to the authors

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