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Feasibility and Tolerability of Controllable Pulse Parameter Transcranial Magnetic Stimulation in Patients with Painful Diabetic Neuropathy: A Case Series Study

Park J, Foglia SD, Drapeau CC, Mayer PV, Shanthanna H, Nelson AJ

International medical case reports journal, 2025

1 citation

Abstract

Abstract This case series highlights the feasibility and tolerability of using controllable pulse parameter Transcranial Magnetic Stimulation (cTMS) in individuals with painful diabetic neuropathy (pDN). cTMS delivers repetitive monophasic pulses, which allows for greater and longer lasting effects compared to traditional repetitive TMS (rTMS). All participants (N = 2) tolerated 10 sessions of cTMS over a two-week period (five days per week) with no discomfort from the stimulation. They reported no pain from the stimulation despite their heightened pain sensitivity as a result of pDN. The cTMS intervention improved their pain and quality of life as determined through questionnaires evaluating pain, depression, anxiety, and other related measures. Notably, cTMS has never been evaluated in diabetic neuropathy, and our data suggest that it is feasible and tolerable in this clinical population. It further proposes a potential therapeutic treatment option for individuals with pDN.

How strong is the evidence?

Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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