Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative Review
Neuropathic pain, affecting 6.9–10% of the general population, has a negative impact on patients’ quality of life and potentially leads to functional impairment and disability. Repetitive transcranial magnetic stimulation (rTMS)—a safe, indirect and non-invasive technique—has been increasingly appli...
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MDPI AG
2023-01-01
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| author | Yuan-Yuan Tsai Wei-Ting Wu Der-Sheng Han Kamal Mezian Vincenzo Ricci Levent Özçakar Po-Cheng Hsu Ke-Vin Chang |
| author_facet | Yuan-Yuan Tsai Wei-Ting Wu Der-Sheng Han Kamal Mezian Vincenzo Ricci Levent Özçakar Po-Cheng Hsu Ke-Vin Chang |
| author_sort | Yuan-Yuan Tsai |
| collection | DOAJ |
| description | Neuropathic pain, affecting 6.9–10% of the general population, has a negative impact on patients’ quality of life and potentially leads to functional impairment and disability. Repetitive transcranial magnetic stimulation (rTMS)—a safe, indirect and non-invasive technique—has been increasingly applied for treating neuropathic pain. The mechanism underlying rTMS is not yet well understood, and the analgesic effects of rTMS have been inconsistent with respect to different settings/parameters, causing insufficient evidence to determine its efficacy in patients with neuropathic pain. This narrative review aimed to provide an up-to-date overview of rTMS for treating neuropathic pain as well as to summarize the treatment protocols and related adverse effects from existing clinical trials. Current evidence supports the use of 10 Hz HF-rTMS of the primary motor cortex to reduce neuropathic pain, especially in patients with spinal cord injury, diabetic neuropathy and post-herpetic neuralgia. However, the lack of standardized protocols impedes the universal use of rTMS for neuropathic pain. rTMS was hypothesized to achieve analgesic effects by upregulating the pain threshold, inhibiting pain impulse, modulating the brain cortex, altering imbalanced functional connectivity, regulating neurotrophin and increasing endogenous opioid and anti-inflammatory cytokines. Further studies are warranted to explore the differences in the parameters/settings of rTMS for treating neuropathic pain due to different disease types. |
| first_indexed | 2024-03-11T08:33:19Z |
| format | Article |
| id | doaj.art-2f3c7708b9d846b6891b9407bdac3059 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-11T08:33:19Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-2f3c7708b9d846b6891b9407bdac30592023-11-16T21:38:44ZengMDPI AGLife2075-17292023-01-0113225810.3390/life13020258Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative ReviewYuan-Yuan Tsai0Wei-Ting Wu1Der-Sheng Han2Kamal Mezian3Vincenzo Ricci4Levent Özçakar5Po-Cheng Hsu6Ke-Vin Chang7Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, TaiwanDepartment of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, TaiwanDepartment of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, TaiwanDepartment of Rehabilitation Medicine, First Faculty of Medicine, General University Hospital in Prague, Charles University, 12800 Prague, Czech RepublicPhysical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, ItalyDepartment of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, TurkeyDepartment of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, TaiwanDepartment of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, TaiwanNeuropathic pain, affecting 6.9–10% of the general population, has a negative impact on patients’ quality of life and potentially leads to functional impairment and disability. Repetitive transcranial magnetic stimulation (rTMS)—a safe, indirect and non-invasive technique—has been increasingly applied for treating neuropathic pain. The mechanism underlying rTMS is not yet well understood, and the analgesic effects of rTMS have been inconsistent with respect to different settings/parameters, causing insufficient evidence to determine its efficacy in patients with neuropathic pain. This narrative review aimed to provide an up-to-date overview of rTMS for treating neuropathic pain as well as to summarize the treatment protocols and related adverse effects from existing clinical trials. Current evidence supports the use of 10 Hz HF-rTMS of the primary motor cortex to reduce neuropathic pain, especially in patients with spinal cord injury, diabetic neuropathy and post-herpetic neuralgia. However, the lack of standardized protocols impedes the universal use of rTMS for neuropathic pain. rTMS was hypothesized to achieve analgesic effects by upregulating the pain threshold, inhibiting pain impulse, modulating the brain cortex, altering imbalanced functional connectivity, regulating neurotrophin and increasing endogenous opioid and anti-inflammatory cytokines. Further studies are warranted to explore the differences in the parameters/settings of rTMS for treating neuropathic pain due to different disease types.https://www.mdpi.com/2075-1729/13/2/258rTMSneuropathic painanalgesianeuromodulationrehabilitation |
| spellingShingle | Yuan-Yuan Tsai Wei-Ting Wu Der-Sheng Han Kamal Mezian Vincenzo Ricci Levent Özçakar Po-Cheng Hsu Ke-Vin Chang Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative Review Life rTMS neuropathic pain analgesia neuromodulation rehabilitation |
| title | Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative Review |
| title_full | Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative Review |
| title_fullStr | Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative Review |
| title_full_unstemmed | Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative Review |
| title_short | Application of Repetitive Transcranial Magnetic Stimulation in Neuropathic Pain: A Narrative Review |
| title_sort | application of repetitive transcranial magnetic stimulation in neuropathic pain a narrative review |
| topic | rTMS neuropathic pain analgesia neuromodulation rehabilitation |
| url | https://www.mdpi.com/2075-1729/13/2/258 |
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