A new treatment for neuropathic pain: a narrative review of non-invasive magnetic stimulation based on the central nervous system

Neuropathic pain is a prevalent condition resulting from damage or dysfunction of the central or peripheral nervous system. With the increasing incidence of neuropathic pain, its management has become a significant public health concern. This review aims to provide a comprehensive review of the mechanisms of action and recent research progress related to the use of non-invasive magnetic stimulation of central nervous system in the treatment of neuropathic pain. The secondary pathophysiological changes in the central nervous system after a lesion or disease of the somatosensory nervous system, including sensitization of ion channels, activation of immune cells, and the involvement of glial-derived mediators, are the underlying mechanisms that lead to the persistence of neuropathic pain. Over the past 20 years, non-invasive magnetic stimulation of the central nervous system has shown its potential for the treatment of chronic pain. Repetitive transcranial magnetic stimulation has emerged as an effective neuromodulation technique, providing substantial pain relief for patients with neuropathic pain. Currently, the therapeutic targets of repetitive transcranial magnetic stimulation primarily include the brain’s M1, insular, and prefrontal cortex regions. Additionally, repetitive trans-spinal magnetic stimulation has been shown to reduce spinal cord neuroinflammation, suggesting that the spinal cord may serve as a novel therapeutic target for managing neuropathic pain, particularly in cases of peripheral or spinal cord injury.