Neuronavigation‑guided rTMS of the facial motor cortex for atypical facial pain: Two case reports.

Dongsheng Xiao, Wei Tao, Yongjie Li, Matilde Balbi, Yuqing Zhang

Abstract readCase Reports

In one paragraph

Article in Clinical neurophysiology practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Dongsheng XiaoQueensland Brain Institute, The University of Queensland, Brisbane, QLD 4072, Australia.

Wei TaoBeijing Functional Neurosurgery Institute, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

Yongjie LiBeijing Functional Neurosurgery Institute, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

Matilde BalbiQueensland Brain Institute, The University of Queensland, Brisbane, QLD 4072, Australia.

Yuqing ZhangBeijing Functional Neurosurgery Institute, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Evaluate safety and analgesic effect of neuronavigation-guided 10 Hz rTMS precisely targeting facial M1 in atypical facial pain (AFP). Methods: Two adults with refractory AFP received 10 daily sessions (2,500 pulses/day) of 10 Hz rTMS at 110 % resting motor threshold. Targeting used MRI/CT-integrated neuronavigation to the facial M1. Pain severity (Barrow Neurological Institute [BNI] scale I-V) and adverse events were recorded through treatment and short follow-up. Results: Both completed treatment without serious adverse events. Case 1 improved from BNI V at baseline to II at end of treatment, persisting BNI III for 15 days. Case 2 improved from BNI IV to I, with BNI III for 2 days after therapy; both reported better sleep and mood. Conclusions: Neuronavigation-guided 10 Hz rTMS of facial M1 was well tolerated and associated with rapid, clinically meaningful analgesia in two AFP cases. Significance: Pilot data support sham-controlled studies to define dose-response and durability, identify responders, and formalize navigated rTMS as a physiological screen to select candidates and targets for implanted brain stimulations.

Indexed as

Atypical facial painFacial motor cortexMotor cortex stimulationNeuronavigationRepetitive transcranial magnetic stimulation

Identifiers

PMID41624049

DOI10.1016/j.cnp.2026.01.001

PMCPMC12856332

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