Evidence map›Paper›PMID 41272835›Full record

ArticleSystematic reviews2025

The cortical mechanisms underlying the analgesic effects of repetitive transcranial magnetic stimulation: protocol for a systematic review and meta-analysis.

Nahian S Chowdhury, Donovan Cheng, Wei-Ju Chang, Negin Hesam-Shariati, Yann Quide, Pedro Henrique Martins da Cunha, Jorge Dornellys da Silva Lapa, Gabriel Taricani Kubota, Karlos Daniell Araújo Dos Santos, Davi Neves Coelho and 2 more

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Article in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Nahian S ChowdhuryCenter for Pain IMPACT, Neuroscience Research Australia, Randwick, Australia. n.chowdhury@neura.edu.au.
Donovan ChengCenter for Pain IMPACT, Neuroscience Research Australia, Randwick, Australia.
Wei-Ju ChangCenter for Pain IMPACT, Neuroscience Research Australia, Randwick, Australia.
Negin Hesam-ShariatiCenter for Pain IMPACT, Neuroscience Research Australia, Randwick, Australia.
Yann QuideCenter for Pain IMPACT, Neuroscience Research Australia, Randwick, Australia.
Pedro Henrique Martins da CunhaPain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil.
Jorge Dornellys da Silva LapaDepartment of Medicine, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
Gabriel Taricani KubotaPain Center, Department of Neurology, University of São Paulo, São Paulo, Brazil.
Karlos Daniell Araújo Dos SantosUniversidade Federal de Roraima, CEUMA University, São Luís, Brazil.
Davi Neves CoelhoFaculty of Medicine, Imperatriz, MA, Brazil.
Daniel Ciampi de AndradeCentre for Neuroplasticity and Pain, Aalborg University, Aalborg, Denmark.
Sylvia GustinCenter for Pain IMPACT, Neuroscience Research Australia, Randwick, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRepetitive transcranial magnetic stimulation (rTMS) is a promising, safe, and non-invasive treatment for pain. However, there is no clear understanding of the cortical mechanisms underlying the analgesic effect of rTMS. One theory is that rTMS-induced analgesia is associated with alterations in corticomotor and cortical excitability, assessed using single-pulse TMS and TMS-electroencephalography (TMS-EEG), respectively. The aim of this systematic review and meta-analysis will be to synthesise the available literature to determine the following: (1) the effect of rTMS on corticospinal and cortical excitability across experimental pain and acute and chronic clinical pain conditions; (2) whether changes in cortical/corticospinal excitability correlate with changes in pain outcomes for these pain types following rTMS. METHODS/ANALYSIS: Electronic databases (Scopus, PubMed, MEDLINE, PsycINFO, and Web of Science) will be searched using a predetermined strategy. All studies published before December 2024 that investigated the effects of rTMS on cortical/corticomotor excitability and pain (experimental, acute or chronic clinical pain) will be included if they meet eligibility criteria. Study identification, data extraction, and risk of bias assessment will be conducted by two independent reviewers, with a third reviewer consulted for any disagreements. We will extract the group level and individual level changes in corticomotor excitability and/or cortical excitability and pain outcomes before and after rTMS. Group level effect sizes of rTMS on corticomotor/cortical excitability and the individual level association between changes in pain and corticomotor/cortical excitability for different pain conditions (experimental, acute or chronic clinical pain) will be synthesized using a random effects meta-analysis. Subgroup analyses are planned, separating effect sizes for different pain conditions and different rTMS protocols. DISCUSSION: This review will provide the evidence for the cortical and corticomotor mechanisms associated with rTMS-induced analgesia, both at a group and individual level. SYSTEMATIC REVIEW REGISTRATION: International Prospective Register of Systematic Reviews CRD42024594054.

Indexed as

AnalgesiaCerebral CortexChronic PainPain ManagementTranscranial Magnetic StimulationHumansMeta-Analysis as TopicMotor CortexSystematic Reviews as TopicAcute painChronic painExperimental painPrimary motor cortexRepetitive transcranial magnetic stimulation

Identifiers

PMID41272835
PMCPMC12639784

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.