Efficacy of Repetitive Transcranial Magnetic Stimulation Over the Primary Cortex in Patients With Neuropathic Pain and Cancer

Inclusion criteria

• Patient affiliated to or entitled under a social security scheme
• Patient who has received informed information about the study and who has co-signed, with the investigator, a consent form to participate in the study.
• Patient aged 18 to 85 (male or female),
• Central or peripheral neuropathic pain related to cancer and/or its treatment;
• Chronic pain (present for more than 4 months) whose intensity is greater than or equal to 4/10 on a VAS (Visual Analogue Scale) numerical scale.
• Pain present on a daily or almost daily basis (at least 4 days a week)
• Patient not completely relieved by recommended first- and second-line drug treatments for neuropathic pain
• Stable analgesic treatment (no new treatment or dosage adjustment) for at least one month and will not need to be modified for the duration of the study.
• Patient can be followed throughout the study.
• Indication for rTMS of the motor cortex by a neurologist.

Exclusion criteria

• Accident at work or litigation,
• Contraindication to rTMS or MRI (treatment with seismotherapy during the previous month; history of cranial trauma; intracranial hypertension; intracerebral metal clip; piercing; pacemaker; insulin pump; metal prosthesis; pregnant or breast-feeding woman; claustrophobia).
• Chronic alcoholism
• Abuse of drugs or psychoactive substances
• Neuropathic pain as part of a progressive pathology (e.g. HIV),
• Presence of other pain of greater intensity than the neuropathic pain leading to inclusion
• Acute stroke (< 3 months)
• Patient with brain tumour lesions
• Patient with infectious or metabolic brain lesions
• Patients with severe or recent cardiac disorders
• Patients with cognitive impairment
• Patient unable to understand informed consent,
• Patients refusing to stop or unable to stop treatments prohibited during the study, such as morphine.
• Patients participating in another research protocol involving a medicinal product within 30 days prior to inclusion.
• Patients deprived of their liberty or under legal protection (guardianship, curatorship, safeguard of justice, family habilitation).