Clinical features of central sensitization moderate the effect of repetitive transcranial magnetic stimulation in chronic low back pain.

Q: What does this research mean for the field?

Active repetitive transcranial magnetic stimulation (rTMS) may hinder recovery and worsen disability in chronic low back pain patients who exhibit high levels of central sensitization. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Philippe Patricio; Jean Tittley; Fábio Carlos Lucas de Oliveira; Mathieu Roy; Luciana Macedo; Jean-Sébastien Roy; Hugo Massé-Alarie

doi:10.1016/j.jpain.2026.106317

May 1, 2026Journal of PainOpen Access

Clinical features of central sensitization moderate the effect of repetitive transcranial magnetic stimulation in chronic low back pain.

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Key Points

This analysis aims to determine how baseline clinical characteristics influence the effectiveness of rTMS and MCE for chronic low back pain.
140 participants were randomized to active or sham rTMS treatment, with or without MCE.
Six potential effect modifiers were evaluated, including kinesiophobia and self-efficacy.
Linear mixed models assessed interaction effects on pain and disability outcomes at 8 weeks.
Active rTMS led to worse disability in patients with high central sensitization scores compared to sham (mean difference 5.66, 95% CI 0.11 to 11.21).
Participants with low CSI scores showed better disability outcomes with active rTMS (mean difference -7.28, 95% CI -12.06 to -2.50).
Positive expectations and higher self-efficacy significantly predicted better outcomes, independent of treatment.

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Implication

Randomized trial investigates how clinical features moderate rTMS effects in chronic low back pain, suggesting tailored approaches.

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Cite This Study

Patricio et al. (2026) studied this question.

synapsesocial.com/papers/6a0aac6d5ba8ef6d83b6fd25 https://doi.org/10.1016/j.jpain.2026.106317

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Clinical features of central sensitization moderate the effect of repetitive transcranial magnetic stimulation in chronic low back pain.

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Clinical features of central sensitization moderate the effect of repetitive transcranial magnetic stimulation in chronic low back pain.

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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