{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:06:02Z","timestamp":1793210762167,"version":"4.5.0"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peripheral neuropathic pain (PNP) results from damage to peripheral nerves, leading to intractable or exaggerated pain. Repetitive transcranial magnetic stimulation (rTMS) is a non\u2010invasive therapeutic method that modulates cortical neuronal activity and can promote endogenous opioid release, with a potential analgesic effect. This meta\u2010analysis evaluates the efficacy and safety of rTMS use in PNP patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Web of Science, Scopus, and the Cochrane Library for randomized controlled trials (RCTs) evaluating rTMS in PNP. The primary outcome was pain intensity. Statistical analysis was performed using Review Manager version 5.4.1. Risk of bias was assessed using the Cochrane RoB 2 tool, and a random\u2010effects model was used to compute pooled estimates, expressed as standardized mean differences (SMD), mean differences (MD), and risk ratios (RR) with 95% confidence intervals (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies with 435 patients were included. rTMS significantly improved pain intensity (SMD\u2009=\u2009\u22121.11, 95% CI: [\u22121.72, \u22120.49];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0004) and achieved a 30% reduction in pain (RR\u2009=\u20093.31, 95% CI: [0.98, 11.20];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05). Improvements in sleep quality (SMD\u2009=\u2009\u22121.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.26) and Patient Global Impression of Change were not statistically significant (RR\u2009=\u20091.70,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.13). Safety analysis showed no significant increase in adverse events such as headache (RR\u2009=\u20091.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.1), dizziness, pain at the stimulation site, sleep disturbances, or cognitive complaints.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>rTMS significantly reduces pain in PNP patients without major safety concerns. While findings support its clinical utility, high heterogeneity and limited long\u2010term data suggest further standardized trials are warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Prospero Registration<\/jats:title>\n                    <jats:p>CRD42024628350<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papr.70169","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T14:06:48Z","timestamp":1779458808000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of Repetitive Transcranial Magnetic Stimulation (\n                    <scp>rTMS<\/scp>\n                    ) in Peripheral Neuropathic Pain: A\n                    <scp>GRADE<\/scp>\n                    \u2010Assessed Meta\u2010Analysis of Randomized Sham\u2010Controlled Trials"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1609-1036","authenticated-orcid":false,"given":"Omar Khaled","family":"Abdelsalam","sequence":"first","affiliation":[{"name":"Faculty of Medicine New Mansoura University  New Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2962-0075","authenticated-orcid":false,"given":"Rashad G.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Mansoura Manchester Program for Medical Education, Faculty of Medicine Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4135-5986","authenticated-orcid":false,"given":"Mostafa Adel T.","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Beni Suef University  Beni Suef Egypt"},{"name":"Medical Research Group of Egypt (MRGE) Negida Academy  Arlington Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5614-6961","authenticated-orcid":false,"given":"Ali I. Abbas","family":"Dawoud","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy  Arlington Massachusetts USA"},{"name":"Faculty of Medicine Al\u2010Azher University Damietta  New Damietta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8684-0060","authenticated-orcid":false,"given":"Rehab Salama Saleh","family":"Labib","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy  Arlington Massachusetts USA"},{"name":"Faculty of Medicine Cairo University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8049-5209","authenticated-orcid":false,"given":"Belal Mohamed","family":"Hamed","sequence":"additional","affiliation":[{"name":"Medical Research Group of Egypt (MRGE) Negida Academy  Arlington Massachusetts USA"},{"name":"Faculty of Medicine Al\u2010Azhar Cairo University  Cairo 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