Review synthesizes rTMS and tDCS efficacy for neuropathic orofacial pain management

This mini-review examines the application of Repetitive Transcranial Magnetic Stimulation (rTMS) and Transcranial Direct Current Stimulation (tDCS) for patients with neuropathic orofacial pain. The scope encompasses various stimulation parameters and locations, though specific study populations and sample sizes are not reported. The review synthesizes qualitative conclusions regarding pain reduction and treatment response patterns rather than providing pooled effect sizes from a meta-analysis.

The authors highlight that high-frequency rTMS targeting the primary motor cortex achieves pain reductions of 30% to 45% for trigeminal and postherpetic neuralgia. Furthermore, stimulation of non-somatotopic hand motor cortex areas produces analgesic effects comparable to facial targets. The review suggests that patients presenting with pure paroxysmal pain may demonstrate a more robust response compared to those with persistent pain, although specific numerical data for these comparisons are not reported.

Significant limitations identified by the authors include small sample sizes and the use of heterogeneous protocols across the included literature. Safety data, such as adverse events or tolerability, were not reported in the source material. Consequently, the authors note that future research should prioritize phenotype-stratified trials to define optimal stimulation parameters and explore synergies with pharmacotherapy. Given the current evidence is limited, clinicians should interpret these findings with restraint until more robust data emerges.