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The following is a summary of “A 5-day course of repetitive transcranial magnetic stimulation before pain onset ameliorates future pain and increases sensorimotor peak alpha frequency,” published in the December 2024 issue of Pain by Chowdhury et al. 

Repetitive transcranial magnetic stimulation (rTMS) has shown assurance in pain management, but it remained unclear whether administering rTMS before pain onset could prevent future prolonged pain episodes.  

Researchers conducted a retrospective study to investigate whether preemptive rTMS could reduce the experimentally induced jaw pain and whether the effects were associated with changes in corticomotor excitability (CME) or sensorimotor peak alpha frequency (PAF).  

They recruited 40 healthy individuals, 21 receiving active rTMS and 19 receiving sham rTMS. Over 5 consecutive days (from day 0 to day 4), participants underwent 1 session of rTMS targeting the left primary motor cortex, PAF, and CME were evaluated on day 0 (before rTMS) and day 4 (after rTMS). Following the final rTMS session, prolonged pain was induced via intramuscular nerve growth factor injection into the right masseter muscle. From day 5 to day 25, participants completed twice-daily electronic diaries, tracking pain during activities such as chewing, yawning, and talking and any functional limitations in jaw movement or muscle soreness.  

The results showed that individuals receiving active rTMS experienced significantly less pain during chewing and yawning than those receiving sham rTMS. Furthermore, active rTMS was associated with increased sensorimotor PAF.  

Investigators concluded that rTMS was the first to be demonstrated, when administered before pain onset, could prevent future pain, suggesting its potential as an effective preventive treatment. 

Source: journals.lww.com/pain/abstract/9900/a_5_day_course_of_repetitive_transcranial_magnetic.779.aspx