Comparison of intermittent theta burst stimulation and high-frequency repetitive transcranial magnetic stimulation on spinal cord injury-related neuropathic pain: A sham-controlled study

The Journal of Spinal Cord Medicine, 2025 · DOI: 10.1080/10790268.2023.2277964 · Published: November 17, 2023

Spinal Cord Injury Neurology Pain Management

Simple Explanation

This study compares two brain stimulation techniques, iTBS and rTMS, for treating neuropathic pain after spinal cord injury. Patients received either real iTBS, real rTMS, or sham rTMS (a fake treatment) over five sessions. The researchers measured pain levels before and after the treatments using several pain assessment tools to see which stimulation method was more effective.

Study Duration

May 2020 to September 2022

Participants

33 patients with spinal cord injury-related neuropathic pain

Evidence Level

Randomized, double-blind, sham-controlled trial

Key Findings

1
Both real iTBS and real rTMS significantly reduced pain compared to the sham rTMS group, according to all pain evaluation tools used.
2
There was no significant difference in pain reduction between the real iTBS and real rTMS groups, suggesting both are equally effective.
3
iTBS may be more advantageous in clinical settings due to its safety, convenience, and patient compliance compared to rTMS.

Research Summary

This study investigated the effects of iTBS and high-frequency rTMS on SCI-related neuropathic pain compared to a sham control group. The results showed that both real iTBS and real rTMS significantly reduced pain levels in SCI patients compared to the sham group. Considering safety, convenience, and compliance, iTBS may be a preferable option over rTMS for treating neuropathic pain in SCI patients.

Practical Implications

Clinical Practice

iTBS and rTMS can be considered as effective non-invasive treatment options for managing neuropathic pain in SCI patients.

Treatment Choice

iTBS might be favored over rTMS due to its potentially better safety profile, shorter treatment duration, and improved patient compliance.

Future Research

Further studies with larger sample sizes and long-term follow-ups are needed to confirm these findings and explore the underlying mechanisms of pain relief.

Study Limitations

1
Small number of participants.
2
Lack of long-term follow-up assessments.
3
The level and completeness of SCI were not used for inclusion or exclusion criteria.

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