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Repetitive Transcranial Magnetic Stimulation for Treating Chronic Neuropathic Pain: a Systematic Review

  • Neuromodulation (AA Abd-Elsayed, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Given pharmacological interventions’ limited efficacy and abundance of its adverse effects, the repetitive transcranial magnetic stimulation (rTMS) is considered a viable non-invasive option for managing chronic neuropathic pain of different origins with promising outcomes.

Purpose of Review

The provision of a systematic review of current literature on rTMS for managing chronic neuropathic pain of different origins, and assess its efficacy and outcomes, highlighting the need for standard protocols for utilizing rTMS.

Recent Findings

Variable stimulation modalities were trialed targeting the M1, DLPFC, and somatosensory cortices S1 and S2. The M1 yielded the best results in 11 of the studies. Frequency of stimulation was variable; however, optimal outcome was with higher frequencies ranging 10–20 Hz rather than low-frequency 1 Hz.

Summary

Repetitive TMS can produce significant relief from chronic neuropathic pain. The lack of standard methods for rTMS, stimulatory parameters, and target stimulation site precludes concluding the optimal modality for stimulation. The practical algorithm by Lefaucheur and Nguyen (Neurophysiol Clin. 49(4):301–7, 2019) can guide setting standardized algorithms for rTMS. Defining optimal stimulation sites, frequencies, and pulses to maximize patient’s pain relief and minimize required rTMS sessions requires further research.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Department of Anaesthesia and Pain Medicine, Manchester University Foundation Trust, Manchester, UK

    Mohamed Attia, David McCarthy & Mowafak Abdelghani

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  1. Mohamed Attia
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Correspondence to Mohamed Attia.

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In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous 3 years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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Attia, M., McCarthy, D. & Abdelghani, M. Repetitive Transcranial Magnetic Stimulation for Treating Chronic Neuropathic Pain: a Systematic Review. Curr Pain Headache Rep 25, 48 (2021). https://doi.org/10.1007/s11916-021-00960-5

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