Table 2.
PICOs included in systematic reviews.
| PICOs number | PICOs in bubble chart | Stimulation site | Frequency (Hz) | Session schedule | Comparison | Population | Outcomes | Systematic reviews included | Individual studies included in the systematic review | Conclusion | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Controlled trial (parallel) | Controlled trial (cross) | Number of studies | Number of SRs involving the Quality (high/moderate/low/critically low) of Individual studies: | ||||||||||
| 1 | DLPFC, 20 Hz, long sessions vs. sham rTMS | Left DLPFC | 20 Hz | 12 sessions | Sham | Migraine | Headache index | Yang [29], Stilling [35], Feng [37], Lan [38], Shirahige [41] | Brighina 2004 | 1 | 0/0/0/1 | Mixed | |
| 2 | DLPFC, 10 Hz, long sessions vs. sham rTMS | Left DLPFC | 10 Hz | 23 sessions | Sham | Migraine | MIDAS | Stilling [35] | Conforto 2014 | 1 | 0/0/0/1 | Potentially worse: immediately | |
| Left DLPFC | 10 Hz | 23 sessions | Sham | Migraine | MIDAS | Yang [29], Stilling [35], Hamid [36], Feng [37], Lan [38], Shirahige [41] | Conforto 2014 | 1 | 0/0/0/1 | No difference: follow-up at 8 weeks | |||
| Left DLPFC | 10 Hz | 15 sessions | Sham | Chronic widespread pain | NRS | Hamid et al. [36], O'Connell [23]∗ | Avery 2015 ∗ | 1 | 1/0/0/1 | Mixed | |||
| Left DLPFC | 10 Hz | 12 sessions | Standard pharmacotherapy | Migraine | VAS | Yang [29], Stilling [35], Feng [37] | Rapinesi 2016 | 1 | 0/0/0/1 | Potentially better | |||
| 3 | DLPFC, 10 Hz, medium sessions vs. sham rTMS | Left DLPFC | 10 Hz | 10 sessions | Sham | BMS | VAS | Yang [29], O'Connell [23] ∗, Herrero Babiloni [27] & | Umezaki 2016 ∗ & | 1 | 1/0/1/1 | Mixed | |
| 4 | DLPFC, 10 Hz, short sessions vs. sham rTMS | Left DLPFC | 10 Hz | 4 sessions | Sham | Mild traumatic brain injury related headache | NRS | Yang [29], Stilling [35] | Leung 2018 | 1 | 0/0/0/1 | Potentially better: at 1 and 4 weeks | |
| Left DLPFC | 10 Hz | 2 rTMS sessions, 1 rTMS + 1 sham | Sham | Postsurgical pain | VAS, morphine use | Yang [29] | Borckardt 2014 | 1 | 0/0/0/1 | No difference | |||
| 5 | DLPFC, 5 Hz, medium sessions vs. sham rTMS | Left DLPFC | 5 Hz | 10 sessions | Migraine | MIDAS | Yang [29], Moisset [31] | Sahu 2019 | 1 | 0/0/0/1 | Potentially better | ||
| 6 | DLPFC, 5 Hz, short sessions vs. sham rTMS | Left DLPFC | 5 Hz | 5 sessions | Sham | Episodic migraine | Attack frequency | Moisset [31] | Amin 2020 | 1 | 0/0/0/1 | Potentially better | |
| 7 | S2,1 Hz, medium sessions vs. sham rTMS | S2 | 1 Hz | 10 sessions | Sham | Chronic visceral pain (visceral pain due to chronic pancreatitis) | VAS | Yang [29], Hamid [36], O'Connell [23]∗, Galhardoni [45] | Fregni 2011 ∗ | 1 | 1/0/0/1 | Mixed | |
| 8 | S2,1 Hz or 20 Hz, short sessions vs. sham rTMS | S2 | 1 Hz or 20 Hz | 1 session | Sham | Chronic pancreatitis pain | VAS | O'Connell [23]∗ | Fregni 2005∗ | 1 | 1/0/0/0 | Unclear | |
| 9 | Vertex,10 Hz, medium sessions vs. sham rTMS | Vertex | 10 Hz | 10 sessions | Sham | SCI | Galhardoni et al. [45] | Yılmaz 2014 | 1 | 0/0/0/1 | No difference | ||
| 10 | Vertex,1 Hz, short sessions vs. sham rTMS | Vertex | 1 Hz | 5 sessions | Sham | Migraine | NRS | Yang [29], Stilling [35], Moisset [31], Feng [37], Shirahige [41] | Teepker 2010 | 1 | 0/0/0/1 | No difference | |
| 11 | PFC, 10 Hz, short sessions vs. sham rTMS | Left PFC | 10 Hz | 3 sessions | Sham | Intractable neuropathic pain of various origins | NRS | Yang [29], Hamid [36], O'Connell [23]∗, Herrero Babiloni&, Kumru [39] | Borckardt 2009∗,& | 2 | 1/0/1/2 | Mixed | |
| Left PFC | 10 Hz | 1 session | Sham | Postsurgical pain | VAS | Yang [29], Goudra [40], Galhardoni [45] | Borckardt 2006 | Mixed | |||||
| Left PFC | 10 Hz | 1 session | Sham | Postsurgical pain | VAS | Yang [29] | Borckardt 2008 | 1 | 0/0/0/1 | Potentially better | |||
| 12 | S2 vs. S1/M1 vs. sham rTMS, 10 Hz, short sessions | Right S2 | 10 Hz | 3 sessions | S1/M1 and sham | Non-specified orofacial pain, trigeminal neuropathic pain | NRS | Yang [29] Herrero Babiloni [27]&, Kumru [39] | Lindholm 2015& | 1 | 0/0/1/1 | Potentially better (S2) | |
| 13 | PMC/DLPFC vs. sham rTMS, 10 Hz, medium sessions | Left PMC/DLPFC | 10 Hz | 10 sessions | Sham | SCI | Pain intensity: VAS | Yu [28], Yang [29], O'Connell [23]∗ | Nardone 2017 ∗ | 2 | 1/0/0/2 | Potentially better (immediate effect) | |
| Left PMC/DLPFC | 10 Hz | 10 sessions | Sham | CPSP | VAS | Xu [30] | de Oliveira 2014 | Potentially better (immediate effect) | |||||
| Left PMC/DLPFC | 10 Hz | 10 sessions | Sham | SCI | Pain intensity: VAS | Yu [28] | Nardone 2017 | 2 | 1/0/1/2 | No difference (follow-up) | |||
| Left PMC/DLPFC | 10 Hz | 10 sessions | Sham | CPSP | VAS | Yang [29], Xu [30], Moisset and Bouhassira [30], Liampas [33], Ramger [26]&, O'Connell [23]∗, Kumru [39], Cragg [42], Chen [43] | de Oliveira 2014∗, & | No difference (from D1 to W4) | |||||
| 14 | Left frontal cortex vs. sham rTMS, 10 Hz, short sessions | Left frontal cortex | 10 Hz | 3 sessions | Sham | Migraine | VAS | Yang [29], Lan [38] | Misra 2013 | 1 | 0/0/0/1 | Potentially better | |
| 15 | Over the superior trapezius muscle vs. sham rTMS, 3 Hz/15 Hz, 10 sessions | Over the superior trapezius muscle | 3 Hz/15 Hz | 10 sessions | Sham | Brachial plexopathy | VAS | Aamir [34], Kumru [39] | Khedr 2012 | 1 | 0/0/0/1 | Potentially better(1 month) | |
| 16 | ACC vs. PSI vs. sham rTMS, 10 Hz, 16 sessions | ACC vs. PSI | 10 Hz | 16 sessions | Sham | CPSP or SCI | NRS | Yang [29], Moisset and Bouhassira [32] | Galhardoni 2019 | 1 | 0/0/0/1 | No difference | |
| 17 | S1, SMA, preM vs. M1 vs. sham rTMS, 5 Hz, short sessions | S1, SMA, preM | 5 Hz | 4 sessions | M1 and sham | NP | VAS | Yang [29], Gatzinsky [22], O'Connell [23]∗, Kumru [39], Chen [43], Jin [44], Galhardoni [45], Leung [46] | Hirayama 2006∗ | 1 | 1/0/0/1 | Mixed | |
| S1, SMA, preM | 5 Hz | 2 sessions | M1 and sham | CPSP, SCI, TGNI, PNI, RA | VAS, SF-MPQ | Kumru [39] | Saitoh 2006 | 1 | 0/0/0/1 | Potentially better (M1, maintained 3 hours) | |||
PICO: population, intervention, control group, outcome; rTMS: repetitive transcranial magnetic stimulation; DLPFC: dorsolateral prefrontal cortex; S2: secondary somatosensory cortex; PFC: prefrontal cortex; PMC: premotor cortex; ACC: anterior cingulate cortex; PSI: posterior superior insula; S1: postcentral gyrus; SMA: supplementary motor area; preM: premotor area. BMS: burning mouth syndrome; SCI: spinal cord injury; CPSP: central poststroke pain; NP: neuropathic pain; TGNI: trigeminal neuropathic pain; PNI: peripheral nerve injury; RA: root avulsion. MIDAS: migraine disability assessment; NRS: numerical rating scale; VAS: visual analog scale; and SF-MPQ: short form of the McGill pain questionnaire. Note: (i) short: 1–5 sessions, medium: 5–10 sessions, and long: >10 sessions. (ii) In the included SRs: high-quality SRs are marked as ∗; &low-quality SRs; and the rest are critically low-quality SRs; (iii) in the primary studies included in SRs: ∗included by high- and critically low-quality SRs, and included by low- and critically low-quality SRs; (iv) in the number of SRs involving the quality (high/moderate/low/critically low) of primary studies): taking the 13th PICO (PMC/DLPFC vs. sham rTMS, 10 Hz, medium sessions), as an example, a total of 2 primary studies were involved. The meaning of 1/0/0/2 and 1/0/1/2 is shown below in Figure 4.