Non-invasive cortical neuromodulation of the primary motor cortex in the treatment of chronic neuropathic pain

My research activities have primarily focused in recent years on non-invasive cortical neuromodulation of the primary motor cortex in the treatment of chronic neuropathic pain.

The first research area involved the validation and optimization of a new transcranial repetitive magnetic stimulation (rTMS) protocol for treating neuropathic pain. We demonstrated the clinical benefit of long-term stimulation, with spaced sessions and without a loading dose, in patients who had previously failed to respond to treatments.

A second research area focused on studying the neurophysiological mechanisms underlying this magnetic stimulation, particularly through imaging exploration. I participated in several studies based on MRI and neurophysiological data monitoring the activity of the autonomic nervous system (ANS), evaluating the influence of psychosocial aspects, especially empathy, in pain perception.

A third research area aimed to understand the physical mechanisms of rTMS by recording the post-mortem decay of fields induced by stimulation to provide reference tables for future deep cortical target stimulations.

Currently, I am conducting several clinical studies, including a bicentric study at the University Hospitals of Lyon and Saint-Etienne. In this study, we are investigating the potential of mirror therapy with a virtual reality headset to enhance the effect of rTMS in patients with upper limb neuropathic pain. This study also includes significant imaging exploration and psychometric testing to phenotype responder patient profiles and understand the mechanisms involved in neuromodulation.

Finally, as a physiotherapist (PT), a part of my research focuses on the role of pain in PTs. I am the principal investigator of a national epidemiological study, PHYSIODOL, currently underway across metropolitan France, studying the prevalence and management of pain by PTs.

My future research perspectives will continue to explore the therapeutic potential of non-invasive cortical neuromodulation and the understanding of the underlying neurophysiological mechanisms. Additionally, I aim to investigate how pain management can be improved in the field of rehabilitation sciences, considering the adaptability and robustness of patients suffering from chronic pain