Effects of multi-session intermittent theta burst stimulation on central neuropathic pain: A randomized controlled trial
Jong-Keun Kim, Hyo Sik Park, Jin Seok Bae, Yong Sung Jeong, Kang Jae Jung, Jong Youb Lim
Abstract
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is one of the effective treatments for neuropathic pain. Little is known about the effects of multi-session theta burst stimulation, one of the new paradigms of rTMS. OBJECTIVE: The aim of this study was to investigate the effects of multi-session intermittent theta burst stimulation (iTBS) on central neuropathic pain, using evaluation tools specific to neuropathic pain. METHODS: Patients with central neuropathic pain diagnosed using Neuropathic Pain Special Interest Group guidelines were recruited. Thirty patients were randomly assigned to either a real or sham iTBS group. Each patient underwent 5 sessions of iTBS; before and after completion of the 5 sessions, participants were evaluated using the self-completed Leeds assessment of neuropathic symptoms and signs (S-LANSS), the numeric rating scale (NRS), the neuropathic pain symptom inventory (NPSI), and the neuropathic pain scale (NPS). RESULTS: S-LANSS, NRS, NPSI, and 3 of 4 NPS combination scores decreased significantly in the real iTBS group but not in the sham iTBS group. No adverse effects were reported during or after iTBS sessions. CONCLUSIONS: Multi-session iTBS was associated with a significant decrease in neuropathic pain, indicating its effectiveness as a treatment for patients with central neuropathic pain.