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Updated: Mar 29, 2026
Repetitive Transcranial Magnetic Stimulation to the Unilateral Hemisphere of Rat Brain
Published on: October 22, 2016
High Frequency Repetitive Transcranial Magnetic Stimulation Therapy For Chronic Neuropathic Pain: A Meta-analysis
Yu Jin1, Guoqiang Xing2, Guangming Li3
1Luzhou Medical College, China.
Background:
Increasing evidence supports an analgesic effect of repetitive transcranial magnetic stimulation (rTMS) for neuropathic pain (NP). However, the optimal parameters of rTMS (stimulation frequency and treatment sessions) for achieving long-term analgesic effects remain unknown. This study analyzed the current findings in the literature.
Objective:
The aim of this study was to assess the optimal parameters of rTMS for NP, including the rTMS sessions needed for inducing acute as well as long-term analgesic effects.
Study Design:
A meta-analysis of the analgesic effect of high frequency rTMS (HF- rTMS) for neuropathic patients.
Setting:
This meta-analysis examined all studies involving the analgesic efficacy of HF-rTMS for NP.
Methods:
PubMed, Embase, and the Cochrane library were searched for clinical studies of rTMS treatment on NP published before December 31, 2014. Crude standardized mean differences (SMD) with 95% confidence interval (CI) were calculated for pain intensity after different treatment sessions (from 1 to 10) and follow-up of one or 2 months after rTMS treatment using random effect models.
Results:
Twenty-five studies (including 32 trials and 589 patients) were selected for the meta-analysis according to the inclusion and exclusion criteria. All 3 HF-rTMS treatments (5, 10, and 20 Hz) produced pain reduction, while there were no differences between them, with the maximal pain reduction found after one and 5 sessions of rTMS treatment. Further, this significant analgesic effect remained forone month after 5 sessions of rTMS treatment.
Limitations:
There are limitations of this meta-analysis. For example, the long-term analgesic effects of different HF-rTMS and low frequency (LF) rTMS sessions, including the single session of rTMS on different NP of varying origins have yet not been evaluated; the full degree of pain relief is still unclear for many rTMS studies.
Conclusions:
HF-rTMS stimulation on primary motor cortex is effective in relieving pain in NP patients. Although 5 sessions of rTMS treatment produced a maximal analgesic effect and may be maintained for at least one month, further large-scale and well-controlled trials are needed to determine if this enhanced effect is specific to certain types of NP such as post-stroke related central NP.
