Non-Invasive Brain Stimulation for Central Neuropathic Pain: An Exploratory Randomized Sham-Controlled Crossover Trial

Background/Objectives: Central neuropathic pain (CNP) is difficult to manage, and comparative evidence for non-invasive brain stimulation is limited. We explored the short-term efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in CNP.

Methods

In this randomized, sham-controlled crossover trial, 26 patients were allocated to active or sham stimulation and received high-frequency rTMS (10 Hz, 2000 pulses/session) and anodal tDCS (2 mA, 30 min) over the primary motor cortex for five days each, separated by a 4-week washout. The primary outcome was change in Numerical Rating Scale (NRS) pain intensity at 1 and 4 weeks, analysed using factorial linear mixed-effects models with and without age adjustment.