Effects of repetitive transcranial magnetic stimulation combined with acupuncture on NLRP3 inflammasome and protease levels in patients with neuropathic pain

Am J Transl Res. 2023 Jul 15;15(7):4699-4708. eCollection 2023.

Abstract

Purpose: This study aimed to investigate whether repetitive transcranial magnetic stimulation (rTMS) combined with acupuncture could alleviate pain in patients suffering from postherpetic neuralgia (PHN) by inhibiting NOD-like receptor 3 (NLRP3) inflammasome activation.

Methods: Data of 92 PHN patients were retrospectively collected. The patients were grouped as control (nerve block), rTMS, and rTMS + acupuncture groups according to treatment methods. The visual analogue scale (VAS) score, as well as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, NLRP3, and Caspase-1 levels of patients in each group prior and post-treatment were analyzed.

Results: The rTMS + acupuncture group showed higher efficacy than the rTMS group and the control group, contributing to markedly lower VAS score, as well as TNF-α, IL-1β, IL-6, NLRP3 and Caspase-1 levels than the other two groups (P < 0.05).

Conclusion: rTMS plus acupuncture can reduce the inflammatory immune response and ease the pain in patients by inhibiting NLRP3 inflammasome and its resulting inflammatory factors, Caspase-1 and IL-1β.

Keywords: IGF-1; NLRP3; Repetitive transcranial magnetic stimulation; acupuncture; inflammatory factor; neuropathic pain.