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The following is a summary of “Repetitive Transcranial Magnetic Stimulation for the Treatment of Complex Regional Pain Syndrome: A Pilot Study,” published in the January 2025 issue of Pain by Foglia et al.
Complex regional pain syndrome (CRPS) is a chronic pain disorder with sensory, motor, and autonomic dysfunction, affecting 26.2 per 1,00,000 people annually, and familiar in females.
Researchers conducted a retrospective study to investigate the feasibility by employing repetitive transcranial magnetic stimulation (rTMS) in patients with CRPS to improve pain intensity and QoL.
They included 6 participants (5 lower limb, 1 upper limb, 42 ± 9 years) in a 9-week rTMS intervention with a 6-month follow-up. Participants completed a 4-week induction phase (5 days/week), followed by a 5-week tapering period with reduced rTMS session frequency and was delivered at 10 Hz for 2000 pulses at 80% of the resting motor threshold over the primary motor cortex. Feasibility was assessed through session attendance. Clinical outcomes were measured using the numerical ratings scale for pain intensity, Pain Catastrophizing scale-EN-SF, PROMIS-29 v2.0 profile, and Rainbow Pain Scale.
The results showed 83% of participants completed the 9-week intervention, indicating feasibility. At 6 months, data was available for 3 participants. A significant 20% reduction in pain intensity was observed immediately after the intervention, while 4 participants exhibited categorical improvements in allodynia following the intervention.
Investigators concluded that rTMS delivered over 9 weeks was feasible and well tolerated in individuals with CRPS, though challenges in 6-month follow-up data collection highlighted the need for strategies to ensure retention in randomized controlled trials.
