Non-Invasive Brain Stimulation for Core Symptoms of Chronic Primary Pain: A Meta-Analysis of RCTs
Alessandra Telesca1,2, Alessandra Vergallito3,4, Anna Vedani5
1Neuroalgology Unit, Department of Clinical Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
Brain Sciences
|July 28, 2026
Summary
Non-invasive brain stimulation (NIBS) effectively improves chronic primary pain (CPP) symptoms like pain intensity and emotional distress. However, longer pain duration may reduce treatment benefits over time.
Area of Science:
- Neuroscience
- Pain Management
- Neuromodulation
Background:
- Chronic primary pain (CPP) is a diagnostic category for pain without clear origin, potentially involving central sensitization.
- Non-invasive brain stimulation (NIBS) targets maladaptive neural activity, offering a potential therapeutic approach for CPP.
- The impact of NIBS on core CPP symptoms was previously unexplored.
Purpose of the Study:
- To meta-analyze the effects of NIBS on pain intensity, emotional distress, and functional disability in CPP patients.
- To investigate NIBS efficacy in improving core CPP symptoms.
Main Methods:
- A systematic review and meta-analysis following PRISMA guidelines.
- Inclusion of randomized clinical trials (RCTs) published up to February 2025.
- Analysis of pre/post or follow-up scores on validated measures for CPP symptoms and quality of life.
Main Results:
- Fifty-four studies (1371 real, 1103 sham stimulation) were included.
- Real NIBS significantly improved CPP symptoms immediately post-treatment and at one-month follow-up.
- Longer CPP duration was associated with reduced short-term emotional distress benefits and diminished long-term outcomes.
Conclusions:
- NIBS shows promise for managing CPP symptoms.
- Standardized NIBS protocols and longer follow-up studies are needed.
- Combining NIBS with other interventions may enhance treatment effectiveness and durability.
