Transcranial Magnetic Stimulation for Peripheral Neuropathy

(rTMS for CIPN Trial)

This trial explores a new method to ease pain from chemotherapy-induced peripheral neuropathy using repetitive transcranial magnetic stimulation (rTMS). This non-invasive treatment uses magnetic fields to stimulate nerve cells in the brain. The researchers aim to determine if rTMS can reduce pain scores for individuals who developed neuropathic pain after certain cancer treatments. Women who have had breast or gynecologic cancer and continue to experience neuropathic pain despite medication may be suitable candidates for this study. As an unphased trial, it offers participants the chance to contribute to innovative research that could lead to new pain relief options.

The trial requires that you have been on a stable dose of your current neuropathic pain medication for at least 6 weeks before joining. However, you might need to stop or adjust other pain medications, as determined by the study doctor. If you are on tricyclic antidepressants, you will need to lower the dose to 50 mg daily at least one week before starting the treatment.

Research shows that repetitive transcranial magnetic stimulation (rTMS) is a safe and non-invasive treatment. Studies have found it well-tolerated for treating nerve pain. For instance, a review of several studies found that rTMS effectively reduced pain without causing significant side effects, especially compared to a placebo (a fake treatment). Additional research supports its safety when used on the motor cortex, the part of the brain controlling voluntary movements. Overall, many studies have used the treatment without reporting major negative effects. This suggests that rTMS is generally safe for people with nerve pain.¹²³⁴⁵

Transcranial Magnetic Stimulation (TMS) is unique because it offers a non-invasive approach to treating peripheral neuropathy, unlike traditional medications that often focus on pain relief through oral drugs. TMS works by using magnetic fields to stimulate nerve cells in the brain, which may help modulate pain signals more directly. Researchers are excited about this treatment because it has the potential to offer relief without the side effects associated with medications like opioids and anticonvulsants. Additionally, TMS could provide an option for those who haven't found success with existing treatments.

Research has shown that repetitive transcranial magnetic stimulation (rTMS), which participants in this trial will receive, can effectively reduce nerve pain. Studies indicate that high-frequency rTMS on the primary motor cortex has helped relieve pain, particularly in patients with nerve pain from conditions affecting the peripheral nerves. In one study, 42% of patients who underwent multiple rTMS sessions reported a pain reduction of more than 30%. Additionally, more frequent rTMS sessions have been linked to even better pain relief. Overall, rTMS appears promising for easing pain related to conditions such as nerve damage from chemotherapy.¹³⁵⁶⁷