The effect of intermittent theta burst stimulation on central poststroke pain: A pilot randomized controlled trial

Central poststroke pain (CPSP) is neuropathic pain caused by a cerebrovascular lesion. Repetitive transcranial magnetic stimulation has been shown to effectively reduce CPSP. Intermittent theta burst stimulation (iTBS), an alternative stimulation method to conventional repetitive transcranial magnetic stimulation, has been shown to have beneficial effects for neuropathic pain. The objective of this study was to investigate the effects of iTBS on CPSP and demonstrate the effects using clinical assessment scales.

Patients with CPSP who met the neuropathic pain criteria of the PainDetect questionnaire (PD-Q), Leeds assessment of neuropathic symptoms and signs (LANSS), and Douleur neuropathique 4 questions (DN4) were recruited. Twenty patients were randomly assigned to a real or sham iTBS and underwent 5 sessions of iTBS to the motor cortex. Before the initial stimulation and after the completion of 5 sessions, PD-Q, LANSS, DN4, and numeric rating scale were assessed.

PD-Q, LANSS, DN4, and numeric rating scale decreased significantly in the real iTBS group but not in the sham iTBS group. There were no adverse effects regarding the iTBS sessions.

iTBS was effective in reducing CPSP. Considering the safety and convenience of application, iTBS can be suggested as an effective treatment for patients with CPSP.