The Impact of Transcranial Magnetic Stimulation (TMS) on Depressive Symptomatology in Patients with Chronic Pain Disorders: A Systematic Review.

Objective: Transcranial Magnetic Stimulation (TMS) is a recognized therapy for treatment-resistant depression and has been studied for its potential in managing chronic pain. Knowing the intrinsic relationship between pain and depressive symptomatology, this systematic review aims to assess the impact of TMS on depressive symptoms in patients with chronic pain.

Materials and methods: Electronic databases were systematically searched until November 2023 for studies applying TMS in chronic pain patients, with an assessment of both pain and depressive symptomatology.

Results: From the records screened, 36 studies met the inclusion criteria for qualitative synthesis, including a total of 1339 unique patients. The results showed heterogeneous protocols with widely different results in depressive symptomatology across the studies, precluding meta-analysis. TMS was considered a safe treatment option with minor side effects.

Conclusions: The impact of TMS on depressive symptomatology among patients with chronic pain is a complex subject. Considering the diversity of the protocols and results encountered, future research should prioritize the establishment of standardized TMS protocols to clarify their efficacy in managing depressive symptoms among these patients. This systematic review highlights the need for further investigation of TMS as a dual therapeutic approach for chronic pain and depressive symptomatology, emphasizing the necessity of improving the protocols to enhance clinical outcomes.