Magnetic pulses to the brain may ease stubborn nerve pain

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Meets Criteria for Chronic Neuropathic Pain (NP): 1. "Pain caused by a lesion or disease of the somatosensory nervous system 2. Intractable pain longer than 6 months after pain onset 3. Baseline VAS score 30-94-mm 4. Currently prescribed pain medication for NP, history of prior medication trials without adequate pain control, or refused treatments for individual reasons 5. Continuous pain in face and/or extremities * Age 18-80 * Any gender and all ethnoracial categories * Stable on chronic pain medications for 4 weeks prior to the study and agreeable to continue throughout the study. These medications include: Tricyclic antidepressants (e.g., nortriptyline, amitriptyline), SNRIs (e.g., duloxetine, venlafaxine), gabapentinoids (e.g., gabapentin, pregabalin), antiepileptics (e.g., valproic acid, carbamazepine, lamotrigine), and daily anti-inflammatories (e.g., meloxicam), among others (as determined by study physician at the time of screening). Note: Medications that are known to increase cortical excitability (e.g., buproprion, maprotiline, tricyclic antidepressants, classical antipsychotics) or to have an inhibitory effect on brain excitability (e.g., antiepileptics, benzodiazepines, and atypical antipsychotics), or any other medications with relative hazard for use in TMS will be allowed upon review of medications and/or motor threshold determination by TMS specialist. * Participants may continue to take as-needed pain medications and record daily usage throughout the experiment * Capacity to provide informed consent * Ability to tolerate study procedures * Successfully complete the screening forms without contraindications Exclusion Criteria: * Neurologic: Dementia, Severe neurocognitive disorder (MoCA \< 22), Severe aphasia, Seizure disorder, certain structural brain lesions (e.g., intracranial mass lesions, hydrocephalus, sequelae of meningitis), or complete paralysis at target site * Psychiatric: DSM Axis I disorder, Suicidal thoughts, prior psychosurgery, prior ECT * Procedural: prior rTMS within 1 year of consent, enrollment in other clinical trial in the past 6 months * TMS contraindications: implanted device; presence of metal in the head, including eyes and ears (excluding dental implants); certain tics; medications or systemic illness that predispose seizure risk * Participants with an unstable physical, systemic, or metabolic disorder (e.g., unstable hypertension, cardiac disease) * Females who are pregnant or nursing * Inability to complete the research study