Repetitive Transcranial Magnetic Stimulation (rTMS) in Postherpetic Neuralgia: A Scoping Review

Introduction: Postherpetic Neuralgia (PHN) is a chronic neuropathic pain condition af-fecting approximately 7–8% of individuals following Herpes Zoster infection. It is characterized by persistent pain and heightened sensitivity (hyperalgesia). Among emerging treatments, Repetitive Transcranial Magnetic Stimulation (rTMS) has shown promise, as it non-invasively modulates neu-ronal excitability through magnetic fields that generate electrical currents in targeted brain regions. Methodology: This review synthesizes recent findings (2014–2024) on the use of rTMS for PHN management. A scoping review was conducted using PubMed, Google Scholar, Scopus, and Web of Science. Seven studies met the inclusion criteria. Key data extracted included study design, stimula-tion parameters, target regions, presence of sham controls, outcomes, and reported side effects. Results: The combined sample comprised 267 participants (139 men, 128 women) with a mean age of 64.42 years. Most studies targeted the primary motor cortex (M1), used a figure-of-eight coil, and applied 10 Hz stimulation with pulse trains of 300-600 pulses. Discussion: The Visual Analog Scale (VAS) was the most common outcome measure. All studies reported pain reduction and improved quality of life, with minimal adverse effects. Conclusion: A recent systematic review and meta-analysis (2024) of RCTs further confirms that rTMS produces significant reductions in VAS scores at 1 month and 3 months post-treatment. Stand-ardized protocols are needed to optimize clinical application.