'Virtual lesion' in pain research; A study on magnetic stimulation of the primary motor cortex

Y. Granovsky, K. S. Liem, I. Weissman-Fogel, D. Yarnitsky, A. Chistyakov, A. Sinai

Research output: Contribution to journalArticlepeer-review


Background 'Virtual lesion' ('VL') is a transient disruption of cortical activity during task performance. It can be induced by single pulses or short trains of transcranial magnetic stimulation (TMS) directed to functionally relevant brain areas. We applied 'VL' methodology of a short train of TMS given on top of experimental tonic pain, expecting to see changes in pain scores. Methods Thirty young healthy subjects (15 women) were assessed with active ('VL') or 'sham' TMS in different sessions, randomly. In each session, 30 sec-long contact heat (47.5 °C, right forearm) was applied stand-alone ('baseline') and with 5 sec-long 10 Hz-TMS over left primary motor cortex (M1) starting at 17 sec of the heat stimulation. Results Pain scores decreased after 'VL' or 'sham' (p < 0.001). Independently of the type of TMS, pain reduction was stronger in women (p = 0.012). A triple Sex x Stimulation type ('VL' or 'sham') x Condition ('baseline' heat pain vs. heat pain with TMS) interaction (p = 0.027) indicated stronger pain reduction by 'VL' in women (p = 0.008) and not in men (p = 0.78) as compared to 'baseline'. Pain catastrophizing and perceived stress ratings affected the model (p = 0.010 and p < 0.001, respectively), but without sex differences. Conclusions This study indicates that interactions between cortical excitability of the motor cortex and nociceptive processing may be gender-related.

Original languageEnglish
Pages (from-to)241-249
Number of pages9
JournalEuropean Journal of Pain
Issue number2
StatePublished - 1 Feb 2016

Bibliographical note

Funding Information:
This study was sponsored by the Israel Science Foundation, Grant no. 518/2012. Thanks to Dr. Elliot Sprecher for his help in the statistical analysis, and to Dr. Ruth Moont for her help in English editing.

Publisher Copyright:
© 2015 European Pain Federation.

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


Dive into the research topics of ''Virtual lesion' in pain research; A study on magnetic stimulation of the primary motor cortex'. Together they form a unique fingerprint.

Cite this