title: High-Frequency Repetitive Transcranial Magnetic Stimulation Reduces Pain in Postherpetic Neuralgia.
abstract: OBJECTIVE
  Postherpetic neuralgia (PHN) is one of the most intractable pain disorders, especially in elderly patients. There is evidence that repetitive transcranial magnetic stimulation (rTMS) reduces neuropathic pain; however, its effectiveness for PHN is unknown. This study investigated the efficacy of high-frequency rTMS in patients with PHN.
  
  
  METHODS
  A total of 40 patients were randomly assigned to receive 10 sessions of real or sham rTMS of the primary motor cortex. Each stimulation session consisted of a series of 300 five-second pulses with a frequency of 10 Hz and an interval of 3 seconds between each train, giving a total of 1500 pulses per session. The primary outcome was pain intensity measured before stimulation from first intervention (T0) to the final stimulation (T10), and 1 and 3 months after final stimulation (T11 and T12). Other outcomes measured included scores on the short form McGill pain questionnaire, self-rating depression scale, quality of life (QOL), sleep quality, the patient global impression of change, medication regulation, and reported adverse events.
  
  
  RESULTS
  The real rTMS group demonstrated greater reduction of visual analogue scale (VAS) than the sham group at each time point except for T0 (P = 0.399) and T1 (P = 0.091). Mean VAS reduction in the real rTMS group was 16.89% for duration of disease longer than 6 months. These analgesic effects were associated with long-term improvement in rating-scale items related to QOL.
  
  
  CONCLUSIONS
  The results suggest that rTMS is an effective and safe therapy in patients with PHN.
authors.affiliation: Department of Pain Management, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
authors.forename: Shu-Min
authors.initials: SM
authors.lastname: Ma
authors.affiliation: Department of Pain Management, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
authors.forename: Jia-Xiang
authors.initials: JX
authors.lastname: Ni
authors.affiliation: Department of Anaesthesiology, University of Hong Kong-Shenzhen Hospital, Guangdong, 518053, China.
authors.forename: Xuan-Ying
authors.initials: XY
authors.lastname: Li
authors.affiliation: Department of Pain Management, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
authors.forename: Li-Qiang
authors.initials: LQ
authors.lastname: Yang
authors.affiliation: Department of Pain Management, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
authors.forename: Yu-Na
authors.initials: YN
authors.lastname: Guo
authors.affiliation: Department of Pain Management, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
authors.forename: Yuan-Zhang
authors.initials: YZ
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D009437:Neuralgia / Q000628:therapy*; D051474:Neuralgia, Postherpetic / Q000175:diagnosis / Q000628:therapy*; D010147:Pain Measurement; D011788:Quality of Life; D050781:Transcranial Magnetic Stimulation / Q000379:methods; D016896:Treatment Outcome
keywords: Neuromodulation; Postherpetic Neuralgia; Repetitive Transcranial Magnetic Stimulation