乳房切除术后疼痛综合征（PMPS）的特征是肋间臂神经病变引起的慢性神经性疼痛，这是一个巨大的临床挑战。随着乳腺癌发病率的激增，迫切需要对PMPS进行有效的干预。为了解决这个问题，我们进行了这项双盲、安慰剂对照、随机临床试验，以研究运动皮层重复经颅磁刺激 (rTMS) 疗法对 PMPS 患者疼痛、生活质量和热敏感性的疗效。 34 名 PMPS 患者在三周内接受了 15 次 rTMS 治疗。这些患者被随机分配到 rTMS 治疗组或假治疗组。使用视觉模拟量表 (VAS) 和简式麦吉尔疼痛问卷 (SF-MPQ) 进行疼痛评估，并通过乳腺癌治疗功能评估 (FACT-B) 进行生活质量评估，在治疗前后进行记录15 场会议。此外，我们使用定量感官测试 (QST) 评估热敏感性。我们的研究结果表明，rTMS 疗法（相对于假疗法）在降低 VAS 和 SF-MPQ 评分 (p < 0.0001)、改善体质 (p = 0.037)、情绪 (p = 0.033) 和功能健康 (p = 0.020) 是生活质量的组成部分，由 FACT-B 量化。我们的研究还发现，rTMS 治疗组的热敏感性显着增强，冷检测阈值 (p = 0.0001)、温检测阈值 (p = 0.0033)、冷痛阈值 (p = 0.0078) 和热痛均有统计学显着改善。耐受阈值 (p = 0.0078)。该研究强调了 rTMS 治疗对 PMPS 患者的疼痛、生活质量和热敏感性产生深远的积极影响，为疼痛管理策略开辟了新途径。© 2024。作者，获得日本乳腺癌协会的独家许可。

Post-mastectomy pain Syndrome (PMPS), characterized by chronic neuropathic pain stemming from intercostobrachial nerve lesions, presents a formidable clinical challenge. With the incidence of breast cancer surging, effective interventions for PMPS are urgently needed. To address this, we conducted this double-blind, placebo-controlled, randomized clinical trial to study the efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) therapy over the motor cortex on pain, quality of life and thermal sensitivity in PMPS patients.We delivered 15 rTMS sessions over three weeks in a cohort of 34 PMPS patients. These patients were allocated randomly to either rTMS therapy or sham therapy groups. Pain assessments, utilizing the Visual Analogue Scale (VAS) and Short Form McGill Pain Questionnaire (SF-MPQ), alongside quality-of-life evaluations through the Functional Assessment of Cancer Therapy-Breast (FACT-B), were recorded before and after the 15 sessions. Additionally, we assessed thermal sensitivity using Quantitative Sensory Testing (QST).Our findings demonstrate the superior efficacy of rTMS therapy (over sham therapy) in reducing VAS and SF-MPQ scores (p < 0.0001), improving physical (p = 0.037), emotional (p = 0.033), and functional well-being (p = 0.020) components of quality of life, as quantified by FACT-B. Our investigation also unveiled marked enhancements in thermal sensitivity within the rTMS therapy group, with statistically significant improvements in cold detection threshold (p = 0.0001), warm detection threshold (p = 0.0033), cold pain threshold (p = 0.0078), and hot pain tolerance threshold (p = 0.0078).The study underscores the profound positive impact of rTMS therapy on pain, quality of life, and thermal sensitivity in patients having PMPS, opening new avenues for pain management strategies.© 2024. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.