Effects of repetitive transcranial magnetic stimulation on neuropathic pain: A systematic review and meta-analysis

Xue Jiang; Wangwang Yan; Ruihan Wan; Yangyang Lin; Xiaoxia Zhu; Ge Song; Kangyong Zheng; Yuling Wang; Xueqiang Wang

doi:10.1016/j.neubiorev.2021.11.037

Effects of repetitive transcranial magnetic stimulation on neuropathic pain: A systematic review and meta-analysis

Neurosci Biobehav Rev. 2022 Jan:132:130-141. doi: 10.1016/j.neubiorev.2021.11.037. Epub 2021 Nov 24.

Authors

Xue Jiang¹, Wangwang Yan¹, Ruihan Wan², Yangyang Lin³, Xiaoxia Zhu³, Ge Song⁴, Kangyong Zheng⁴, Yuling Wang⁵, Xueqiang Wang⁶

Affiliations

¹ Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China; Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
² Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China; Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
³ Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁴ Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
⁵ Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address: wangyul@mail.sysu.edu.cn.
⁶ Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China; Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China. Electronic address: wangxueqiang@sus.edu.cn.

PMID: 34826512
DOI: 10.1016/j.neubiorev.2021.11.037

Abstract

Neuropathic pain (NP) is a chronic pain condition caused by lesion or disease of the somatosensory nervous system. Repetitive transcranial magnetic stimulation (rTMS) is a neuroregulatory tool that uses pulsed magnetic fields to modulate the cerebral cortex. This review aimed to ascertain the therapeutic effect of rTMS on NP and potential factors regulating the therapeutic effect of rTMS. Database search included Web of Science, Embase, Pubmed, and Cochrane Library from inception to July 2021. Eligible studies included randomized controlled studies of the analgesic effects of rTMS in patients with NP. Thirty-eight studies were included. Random effect analysis showed effect sizes of -0.66 (95 % CI, -0.87 to -0.46), indicating that real rTMS was better than sham condition in reducing pain (P < 0.001). This comprehensive review indicated that stimulation frequency, intervention site, and location of lesion were important factors affecting the therapeutic effect. The findings of this study may guide clinical decisions and future research.

Keywords: Meta-analysis; Neuropathic pain; Repetitive transcranial magnetic stimulation; rTMS.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Cerebral Cortex
Chronic Pain* / etiology
Humans
Neuralgia* / etiology
Neuralgia* / therapy
Pain Management / adverse effects
Transcranial Magnetic Stimulation
Treatment Outcome