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已发表论文
重复经颅磁刺激与三叉神经痛安慰剂效应的神经机制：来自功能性磁共振成像网络动态的证据
Authors Liu Y, Chen H, Chen S, Huang L, Jin Z, Guo X , Jiang X, Wang Y
Received 16 June 2025
Accepted for publication 21 November 2025
Published 2 December 2025 Volume 2025:18 Pages 6413—6422
DOI https://doi.org/10.2147/JPR.S547405
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Rune Häckert Christensen
Ying Liu,1,* Hao Chen,1 Suhui Chen,2 Liangjiecheng Huang,3 Zhiying Jin,3 Xuanqi Guo,3 Xiaofeng Jiang,4 Ying Wang4– 6,*
1Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China; 2Department of Rehabilitation, The First Affiliated Hospital of USTC, Hefei, Anhui, 230001, People’s Republic of China; 3School of Humanities and Social Sciences, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China; 4Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China; 5Anhui Provincial Stereotactic Neurosurgical Institute, Hefei, Anhui, 230001, People’s Republic of China; 6Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, 230001, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaofeng Jiang, Email xfjiang110@126.com Ying Wang, Email wy1987@ustc.edu.cn
Objective: Repetitive transcranial magnetic stimulation (rTMS) has been suggested to possess analgesic properties, yet its efficacy in treating trigeminal neuralgia (TN) remains uncertain.
Methods: In this randomized, double-blind trial, thirty-four patients were randomly allocated to one of three groups: active M1-targeted rTMS, sham stimulation, or active stimulation of the dorsolateral prefrontal cortex (dlPFC) as a control. The treatment protocol spanned two weeks, consisting of two 5-day stimulation sessions separated by a 2-day interval. MRI and clinical outcomes (VAS, Hamilton Anxiety/Depression Scales) were assessed pre-/post-intervention and at one-month follow-up.
Results: Significant reductions in pain, anxiety, and depression occurred across all groups. Neuroimaging revealed decreased insular cortex activation universally, while increased frontal lobe activity emerged specifically in sham and control groups. Notably, no intergroup differences in clinical outcomes were observed despite distinct neural pathways, specifically involving the insula rather than the prefrontal cortex.
Conclusion: In the active rTMS group, clinical improvements were associated with modulation of the insula, reflecting targeted neurophysiological effects. In contrast, improvements in the sham group were linked to increased prefrontal and orbitofrontal cortex activation, consistent with placebo-related mechanisms.
Significance: This study unveils the critical role of cognitive-emotional pathways in rTMS efficacy, urging integration of neurobiological and psychological strategies for TN therapies.
Plain Language Summary: 1. All groups showed pain reduction in TN, revealing strong placebo effects in rTMS treatment.2. rTMS decreased insula (pain) but increased prefrontal activity (anticipation), showing dual pain control.3. Highlights rTMS’s dual action on brain pain networks and cognitive modulation.
Keywords: placebo effect, rTMS, TN, pain perception and expectation
1Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China; 2Department of Rehabilitation, The First Affiliated Hospital of USTC, Hefei, Anhui, 230001, People’s Republic of China; 3School of Humanities and Social Sciences, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China; 4Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China; 5Anhui Provincial Stereotactic Neurosurgical Institute, Hefei, Anhui, 230001, People’s Republic of China; 6Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, 230001, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaofeng Jiang, Email xfjiang110@126.com Ying Wang, Email wy1987@ustc.edu.cn
Objective: Repetitive transcranial magnetic stimulation (rTMS) has been suggested to possess analgesic properties, yet its efficacy in treating trigeminal neuralgia (TN) remains uncertain.
Methods: In this randomized, double-blind trial, thirty-four patients were randomly allocated to one of three groups: active M1-targeted rTMS, sham stimulation, or active stimulation of the dorsolateral prefrontal cortex (dlPFC) as a control. The treatment protocol spanned two weeks, consisting of two 5-day stimulation sessions separated by a 2-day interval. MRI and clinical outcomes (VAS, Hamilton Anxiety/Depression Scales) were assessed pre-/post-intervention and at one-month follow-up.
Results: Significant reductions in pain, anxiety, and depression occurred across all groups. Neuroimaging revealed decreased insular cortex activation universally, while increased frontal lobe activity emerged specifically in sham and control groups. Notably, no intergroup differences in clinical outcomes were observed despite distinct neural pathways, specifically involving the insula rather than the prefrontal cortex.
Conclusion: In the active rTMS group, clinical improvements were associated with modulation of the insula, reflecting targeted neurophysiological effects. In contrast, improvements in the sham group were linked to increased prefrontal and orbitofrontal cortex activation, consistent with placebo-related mechanisms.
Significance: This study unveils the critical role of cognitive-emotional pathways in rTMS efficacy, urging integration of neurobiological and psychological strategies for TN therapies.
Plain Language Summary: 1. All groups showed pain reduction in TN, revealing strong placebo effects in rTMS treatment.2. rTMS decreased insula (pain) but increased prefrontal activity (anticipation), showing dual pain control.3. Highlights rTMS’s dual action on brain pain networks and cognitive modulation.
Keywords: placebo effect, rTMS, TN, pain perception and expectation