Format

Send to

Choose Destination
Arch Phys Med Rehabil. 2015 Apr;96(4 Suppl):S156-72. doi: 10.1016/j.apmr.2014.11.010. Epub 2014 Nov 28.

Repetitive transcranial magnetic stimulation in chronic pain: a review of the literature.

Author information

1
Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil.
2
INSERM U-987, CHU Ambroise Paré, APHP, Boulogne-Billancourt, France; University of Versailles-Saint-Quentin, Versailles, France.
3
Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil; Pain Center, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil.
4
Pain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil; Pain Center, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil. Electronic address: ciampi@usp.br.

Abstract

OBJECTIVE:

To review the literature on the analgesic effects of repetitive transcranial magnetic stimulation (rTMS) in chronic pain according to different pain syndromes and stimulation parameters.

DATA SOURCES:

Publications on rTMS and chronic pain were searched in PubMed and Google Scholar using the following key words: chronic pain, analgesia, transcranial magnetic stimulation, neuropathic pain, fibromyalgia, and complex regional pain syndrome.

STUDY SELECTION:

This review only included double-blind, controlled studies with >10 participants in each arm that were published from 1996 to 2014 and written in English. Studies with relevant information for the understanding of the effects of rTMS were also cited.

DATA EXTRACTION:

The following data were retained: type of pain syndrome, type of study, coil type, target, stimulation intensity, frequency, number of pulses, orientation of induced current, number of session, and a brief summary of intervention outcomes.

DATA SYNTHESIS:

A total of 33 randomized trials were found. Many studies reported significant pain relief by rTMS, especially high-frequency stimulation over the primary motor cortex performed in consecutive treatment sessions. Pain relief was frequently >30% compared with control treatment. Neuropathic pain, fibromyalgia, and complex regional pain syndrome were the pain syndromes more frequently studied. However, among all published studies, only a few performed repetitive sessions of rTMS.

CONCLUSIONS:

rTMS has potential utility in the management of chronic pain; however, studies using maintenance sessions of rTMS and assessing the effects of rTMS on the different aspects of chronic pain are needed to provide a more solid basis for its clinical application for pain relief.

KEYWORDS:

Analgesia; Chronic pain; Complex regional pain syndromes; Fibromyalgia; Low back pain; Neuropathic pain; Rehabilitation; Transcranial magnetic stimulation

PMID:
25437106
DOI:
10.1016/j.apmr.2014.11.010
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center