The following is a summary of “Beyond trial-and-error: Individualizing therapeutic transcranial neuromodulation for chronic pain,” published in the August 2023 issue of Pain by Andrade et al.

While repetitive transcranial magnetic stimulation (rTMS) to the motor cortex offers added relief for some treatment-resistant chronic pain individuals, its effectiveness isn’t guaranteed for every patient. Researchers performed a retrospective study to present and discuss ongoing attempts to personalize rTMS for chronic pain.

They systematically reviewed relevant scientific publications in significant databases like PubMed and EMBASE up to March 2023. Furthermore, the assessment included studies dedicated to uncovering the mechanism of rTMS analgesic effects in humans, primates, and rodents.

The results showed various methods for customizing cortical neuromodulation, including predicting response via rTMS, altering stimulation patterns, targeting non-motor areas, adjusting based on cortical networks/rhythms, deep sensory profiling, and tailoring motor rTMS specifics. Except for prediction-based rTMS, these approaches generally hold limited or moderate evidence levels.

They concluded that although current evidence is limited, cortical stimulation offers multiple mechanisms of action and possibilities for individualization, making it a promising treatment for chronic pain.

Source: onlinelibrary.wiley.com/doi/full/10.1002/ejp.2164