Defrin et al. 2007
Israel
PEDro=10
RCT
N=12

Population: SCI: Mean age = 54 yrs; Gender: males = 7, females = 4.
Treatment: Patients were randomly placed into two groups: real or sham 10 daily motor rTMS treatments (500 trains at 5 Hz for 10s; total of 5000 pulses at intensity of 115% of motor threshold) over a 2 week period, using figure-of-8 coil over the vertex.
Outcome Measure: Chronic pain intensity (visual analog scale [VAS]) Chronic pain experience (McGill Pain Questionnaire [MPQ]), pain threshold, and level of depression (Beck Depression Inventory [BDI]).

1. The real and sham TMS stimulated similar, significant decreases in VAS scores (P<.001) following all of the 10 treatment sessions, and in VAS and MPQ scores following the final treatment series.
2. The reduction in MPQ scores in the real rTMS group continued during the follow-up period.
3. There was no significance between group differences in the magnitude of pain reduction.
4. At follow-up, patients in the rTMS group reported a 30% reduction in chronic pain intensity, compared to a 10% pain reduction reported by patients in the sham TMS group.
5. A significant increase in heat-pain threshold was found only for patients in the real rTMS group (4°C, P<0.05) at the end of the series.
6. There was a significant difference in the magnitude of change in pain threshold between the real and sham TMS groups (P<0.05).
7. Real and sham TMS groups showed a significant decrease in BDI values following the treatment period in comparison to pre-treatment BDI values (P<0.01).
8. This reduction was maintained by both groups at follow-up (P<0.01).
9. Only patients in the rTMS treatment group exhibited a decreased level of depression during follow-up in comparison to the values at the end of treatment (P<0.05).