La stimulation magnétique transcrânienne à visée antalgique dans les douleurs chroniques d’endométriose : étude de faisabilité

Anne Pinot-Monange
In: https://dumas.ccsd.cnrs.fr/dumas-02022930 · 2018 · W2936619950
Non-randomised trial OA: green CC0
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This feasibility study of transcranial magnetic stimulation for chronic endometriosis pain in twelve patients demonstrated good tolerance and significant improvements in digestive quality of life, though further research is needed to confirm analgesic efficacy.

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Abstract

Introduction : Dans la pathologie endometriosique, malgre une prise en charge pluridisciplinaire medico-chirurgicale associant therapeutiques hormonales, resection chirurgicale complete, antalgiques classiques ou adaptees aux douleurs neuropathiques, il existe dans certains cas une persistance de ces douleurs a l’origine d’un retentissement social et psychologique important. La stimulation magnetique transcrânienne (SMT) pourrait etre une solution pour ces patientes. Elle a deja prouve son efficacite antalgique sur differents types de douleur notamment viscerale, mais n’a jamais ete utilisee a visee antalgique dans l’endometriose. Objectifs : (1) Evaluer la faisabilite de la SMTr a visee antalgique sur les douleurs chroniques refractaires d’endometriose. (2) Evaluer l’efficacite de la SMTr sur ces douleurs. (3) Evaluer la variation de la qualite de vie, anxiete, ressenti de la douleur. Methodes : Douze patientes ont ete incluses. Evaluation de l’EVA quotidienne sur un mois avant puis apres le traitement. Evaluation de la tolerance a J8 post SMTr. Remplissage des questionnaires de qualite de vie, anxiete avant et a J8 et J28 post SMTr. Resultats : Nous avons demontre la faisabilite de ce traitement avec 83,33% de bonne tolerance. Deux groupes de patientes ont pu etre definis : le groupe « repondeuses » qui etait significativement ameliore par rapport au groupe « non repondeuses » (p=0,004). Nous avons trouve une amelioration significative de la qualite de vie digestive a J8 (p=0,04) puis a J28 apres le traitement par SMTr (p=0,02). Conclusion : Notre etude a ete la premiere a demontrer la faisabilite de la SMTr dans les douleurs chroniques d’endometriose. D’autres etudes sont cependant necessaires pour evaluer l’efficacite antalgique de ce traitement.
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