Yang Seoyon, Chang Min Cheol
Department of Rehabilitation Medicine, Ewha Woman's University Seoul Hospital, Ewha Woman's University School of Medicine, Seoul, South Korea.
Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, South Korea.
Front Neurol. 2020 Feb 18;11:114. doi: 10.3389/fneur.2020.00114. eCollection 2020.
Recently, clinicians have been using repetitive transcranial magnetic stimulation (rTMS) for treating various pain conditions. This systematic narrative review aimed to examine the use and efficacy of rTMS for controlling various pain conditions. A PubMed search was conducted for articles that were published until June 7, 2019 and used rTMS for pain alleviation. The key search phrase for identifying potentially relevant articles was (repetitive transcranial magnetic stimulation AND pain). The following inclusion criteria were applied for article selection: (1) patients with pain, (2) rTMS was applied for pain management, and (3) follow-up evaluations were performed after rTMS stimulation to assess the reduction in pain. Review articles were excluded. Overall, 1,030 potentially relevant articles were identified. After reading the titles and abstracts and assessing eligibility based on the full-text articles, 106 publications were finally included in our analysis. Overall, our findings suggested that rTMS is beneficial for treating neuropathic pain of various origins, such as central pain, pain from peripheral nerve disorders, fibromyalgia, and migraine. Although data on the use of rTMS for orofacial pain, including trigeminal neuralgia, phantom pain, low back pain, myofascial pain syndrome, pelvic pain, and complex regional pain syndrome, were promising, there was insufficient evidence to determine the efficacy of rTMS for treating these conditions. Therefore, further studies are needed to validate the effects of rTMS on pain relief in these conditions. Overall, this review will help guide clinicians in making informed decisions regarding whether rTMS is an appropriate option for managing various pain conditions.
最近，临床医生一直在使用重复经颅磁刺激（rTMS）来治疗各种疼痛病症。本系统叙述性综述旨在研究rTMS在控制各种疼痛病症方面的应用及疗效。我们在PubMed上搜索了截至2019年6月7日发表的、使用rTMS缓解疼痛的文章。用于识别潜在相关文章的关键搜索短语是（重复经颅磁刺激 AND 疼痛）。文章选择采用以下纳入标准：（1）疼痛患者；（2）应用rTMS进行疼痛管理；（3）在rTMS刺激后进行随访评估以评估疼痛减轻情况。综述文章被排除。总体而言，共识别出1030篇潜在相关文章。在阅读标题和摘要并根据全文评估合格性后，最终有106篇出版物纳入我们的分析。总体而言，我们的研究结果表明，rTMS有利于治疗各种起源的神经性疼痛，如中枢性疼痛、周围神经疾病引起的疼痛、纤维肌痛和偏头痛。尽管关于rTMS用于治疗口面部疼痛（包括三叉神经痛、幻肢痛、腰痛、肌筋膜疼痛综合征、盆腔疼痛和复杂性区域疼痛综合征）的数据很有前景，但尚无足够证据确定rTMS治疗这些病症的疗效。因此，需要进一步研究来验证rTMS对这些病症疼痛缓解的效果。总体而言，本综述将有助于指导临床医生就是否将rTMS作为管理各种疼痛病症的合适选择做出明智决策。
