Published online Mar 27, 2016. doi: 10.5313/wja.v5.i1.15
Peer-review started: June 30, 2015
First decision: September 17, 2015
Revised: November 26, 2015
Accepted: December 13, 2015
Article in press: December 15, 2015
Published online: March 27, 2016
Processing time: 272 Days and 12.9 Hours
Treatment for chronic pain is frequently unsuccessful or characterized by side-effects. The high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) has been suggested in the management of refractory chronic pain. Various studies have shown that HF-rTMS sessions of long-duration applied at primary motor cortex induce pain relief through mechanisms of plastic changes. Efficacy of rTMS mostly depends on stimulation parameters, but this aspect requires better characterization. A rationale to target other cortical areas exists. Current data are promising, but a careful analysis of stimulation settings and maintenance treatment design are need.
Core tip: The high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) is emerging as a possible approach for pain relief. The HF-rTMS delivered to motor cortex modulates brain network implicated in pain processes, facilitating descending pain inhibitory mechainsms. Current data are promising, but a careful analysis of stimulation settings and maintenance treatment design are necessary.