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Non-Invasive Brain Stimulation as a Tool to Decrease Chronic Pain in Current Opiate Users: A Parametric Evaluation of
Julia P Imperatore1, Daniel M McCalley1, Jeffrey J Borckardt1,2
1Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
Focus (American Psychiatric Publishing)
|August 11, 2026
Summary
Motor cortex (MC) transcranial magnetic stimulation (TMS) significantly reduced pain interference and opiate cravings more than dorsolateral prefrontal cortex (DLPFC) TMS in chronic pain patients. This suggests MC is a promising target for opiate dependence treatment.
Area of Science:
- Neurology
- Pain Management
- Addiction Medicine
Background:
- Chronic pain management is challenged by opiate misuse.
- Transcranial magnetic stimulation (TMS) offers a non-invasive therapeutic option.
- Optimal TMS target (dorsolateral prefrontal cortex vs. motor cortex) for chronic pain and opiate use remains unclear.
Purpose of the Study:
- To directly compare the efficacy of dorsolateral prefrontal cortex (DLPFC) versus motor cortex (MC) TMS.
- To assess the impact on pain severity and the urge to use opiates in chronic pain patients.
Main Methods:
- Twenty-two chronic pain patients using prescription opiates were randomized.
- 10 sessions of 10 Hz repetitive TMS (rTMS) were administered to either left DLPFC or left MC.
- Multivariate linear models analyzed effects on pain (Brief Pain Inventory) and opiate urge.
Main Results:
- Twenty participants completed the study.
- Motor cortex (MC) stimulation showed significantly greater reduction in pain interference compared to DLPFC stimulation.
- MC stimulation demonstrated larger effect sizes for pain interference and opiate urge.
Conclusions:
- The motor cortex (MC) shows promise as a therapeutic target.
- MC TMS may be effective in reducing opiate dependence and pain interference.
- Further research supports MC TMS for chronic pain patients misusing opiates.
