A 184-patient sham-controlled trial reported clinically meaningful pain reductions in patients with chronic neuropathic pain following five weeks of high-frequency motor cortex TMS. Average pain intensity dropped by 32% in the active arm versus 14% in sham, with effects sustained at 12-week follow-up in approximately half of responders.
The trial enrolled patients with peripheral neuropathic pain refractory to standard pharmacological treatment, including gabapentinoids and duloxetine. Most patients had been in pain for more than two years before enrollment.
Motor cortex TMS for chronic pain has been studied for two decades but evidence has been mixed and pivotal trial data limited. The current study, conducted at six European centers, is among the largest sham-controlled trials and is expected to influence European pain management guidelines.
U.S. coverage for TMS in chronic pain remains rare and largely limited to research settings. The authors note that the protocol differs from depression-targeted TMS in both stimulation site and parameters, requiring clinic-level expertise that is not yet broadly available.
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Reporting based on coverage from Pain. This article is editorial summary intended for general information; it is not medical advice.