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Updated: May 31, 2025
Author Spotlight: Insights into Remotely Supervised Neuromodulation Procedure for Phantom Limb Pain
Published on: March 1, 2024
Efficacy of repetitive transcranial magnetic stimulation for phantom limb pain- a meta analysis of randomized
Fnu Chandni1, Fnu Savanti2, Rohit Kumar3
1Isra University, Hyderabad, Sindh, Pakistan.
Introduction:
Phantom limb pain (PLP) is a neuropathic syndrome experienced by the majority of amputees. Various treatment options are available for amputees suffering from PLP including pharmacological, psychological and neuromodulation techniques. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique that has proven its efficacy in alleviating PLP. Hence, we aimed to conduct a meta-analysis to evaluate the effectiveness of rTMS in improving pain in patients with PLP.
Methods:
Literature search was carried out on 5 electronic databases from the inception of the paper till 13th August, 2024. Randomized Controlled Trials evaluating the efficacy of rTMS in patients with PLP against a control group were included in our study. The Visual Analogue Scoring (VAS) system was used to evaluate the severity of pain. Quality assessment was performed with the Cochrane bias assessment tool and data was pooled on Review manager using the Mantel-Haenszel Random-effects model.
Results:
5 RCTs included in this paper were included and consisted of 140 participants experiencing PLP. There was a significant reduction in pain score in the rTMS group at the end of treatment when compared to the control group (P = 0.00001). A drop out sensitivity analysis significantly improved the results by reducing the heterogeneity to null (P = 0.00001). After 30 days of treatment, there was a significant difference of pain score from baseline in rTMS groups.
Conclusion:
Our meta-analysis demonstrates the role of rTMS in significantly reducing VAS score in patients with PLP. In the future, larger clinical trials are required that evaluate the long-term efficacy profile of rTMS to establish it as a mainstay of therapy in patients with PLP.
