Effect of TMS on Neuropathic Pain for Patients With Sci

The Effect of Transcranial Magnetic Stimulation Applied to the Primary Motor Cortex and Anterior Cingulate Cortex on Refractory Neuropathic Pain in Spinal Cord Injury

The aim of this study is to evaluate the efficacy of rTMS targeting the anterior cingulate cortex, another stimulation site that may be effective in the treatment of neuropathic pain, and to compare it with motor cortex stimulation.

Inclusion Criteria:

1. Patients for whom at least 12 months have passed since the date of the event
2. Patients who meet the International Pain Working Group's criteria for central neuropathic pain below the level of the lesion and who have had pain for at least 6 months
3. Patients aged 18-65
4. Pain not attributable to other causes such as rheumatological diseases or diabetes
5. Patients with VAS > 4 despite maximum dose of pharmacological agents (anticonvulsants, antidepressants, narcotics), exercise and physical therapy agents, taking into account renal function tests and other comorbidities

Exclusion Criteria:

1. History of epilepsy
2. Metallic implant in the scalp
3. Cochlear implant
4. Spinal cord stimulator
5. Pacemaker
6. Presence of psychiatric illness
7. Pregnancy