{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:50:47Z","timestamp":1787878247325,"version":"build-2784847793"},"reference-count":77,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006190","name":"Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006190","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec><jats:title>Context<\/jats:title><jats:p>Postherpetic neuralgia (PHN) is a refractory neuropathic pain condition in which new treatment options are being developed. Repetitive transcranial magnetic stimulation (rTMS) may have the potential to reduce pain sensations in patients with postherpetic neuralgia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study investigated the efficacy on postherpetic neuralgia by stimulating two potential targets, the motor cortex (M1) and the dorsolateral prefrontal cortex (DLPFC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a double-blind, randomised, sham-controlled study. Potential participants were recruited from Hangzhou First People\u2019s Hospital. Patients were randomly assigned to either the M1, DLPFC or Sham group. Patients received ten daily sessions of 10-Hz rTMS in 2 consecutive weeks. The primary outcome measure was visual analogue scale (VAS) assessed at baseline, first week of treatment (week 1), post-treatment (week 2), 1-week (week 4), 1-month (week 6) and 3-month (week 14) follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of sixty patients enrolled, 51 received treatment and completed all outcome assessments. M1 stimulation resulted in a larger analgesia during and after treatment compared to the Sham (week 2 \u2013 week 14, <jats:italic>p<\/jats:italic> &amp;lt;\u20090.005), as well as to the DLPFC stimulation (week 1 \u2013 week 14, <jats:italic>p<\/jats:italic> &amp;lt;\u20090.05). In addition to pain, sleep disturbance was significantly improved and relieved by targeting either the M1 or the DLPFC (M1: week 4 \u2013 week 14, <jats:italic>p<\/jats:italic> &amp;lt;\u20090.01; DLPFC: week 4 \u2013 week 14, <jats:italic>p<\/jats:italic> &amp;lt;\u20090.01). Moreover, pain sensations following M1 stimulation uniquely predicted improvement in sleep quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>M1 rTMS is superior to DLPFC stimulation in treating PHN with excellent pain response and long-term analgesia. Meanwhile, M1 and DLPFC stimulation were equally effective in improving sleep quality in PHN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.chictr.org.cn\/<\/jats:ext-link>, identifier ChiCTR2100051963.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnins.2023.1158737","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T06:36:07Z","timestamp":1683873367000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["A randomised sham-controlled study evaluating rTMS analgesic efficacy for postherpetic neuralgia"],"prefix":"10.3389","volume":"17","author":[{"given":"Huan","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manli","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianwei","family":"Che","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1016\/j.sleep.2006.08.003","article-title":"Validity of the Pittsburgh sleep quality index (PSQI) among Nigerian university students","volume":"8","author":"Aloba","year":"2007","journal-title":"Sleep Med."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1097\/j.pain.0000000000000510","article-title":"Repetitive transcranial magnetic stimulation and transcranial direct-current stimulation in neuropathic pain due to radiculopathy: a randomized sham-controlled comparative study","volume":"157","author":"Attal","year":"2016","journal-title":"Pain"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3328","DOI":"10.1093\/brain\/awab208","article-title":"Repetitive transcranial magnetic stimulation for neuropathic pain: a randomized multicentre sham-controlled trial","volume":"144","author":"Attal","year":"2021","journal-title":"Brain"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1002\/ejp.864","article-title":"Analgesic effects of navigated motor cortex rTMS in patients with chronic neuropathic pain","volume":"20","author":"Ayache","year":"2016","journal-title":"Eur. 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