To evaluate the therapeutic effectiveness of high-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) for managing central post-stroke pain (CPSP).

Forty-six patients with CPSP admitted to the Neurorehabilitation Department of Shengli Oilfield Central Hospital between January 2021 and December 2022 were enrolled and randomly assigned to a control group and an experimental group, with 23 patients in each group. Both groups of patients received basic rehabilitation treatment, with the control group receiving sham stimulation and the experimental group receiving 10 Hz rTMS for 4 weeks of treatment; One patient in the experimental group and three patients in the control group withdrew from the study due to inability to tolerate rTMS. The visual analogue scale for pain (VAS), Barthel index, Hamilton anxiety scale (HAMA), and Hamilton depression scale (HAMD) were employed to conduct a quantitative assessment of the patients' pain experience, daily living activity (ADL) capabilities, as well as their anxiety and depression states before and after treatment. Meanwhile, all adverse events that transpired throughout the treatment were carefully recorded.

Compared with before treatment, the VAS, HAMA, and HAMD scores between two groups decreased after treatment, and the experimental group showed a more significant decrease, with statistically significant differences (P<0.05). Compared with before treatment, the Barthel index of both groups of patients increased significantly (P<0.05), but the difference in Barthel index between the experimental group and the control group before and after treatment was not statistically significant (P>0.05). Two patients had headache, and the symptoms improved after reducing the intensity of rTMS, while other patients did not have study related adverse events.

The application of 10 Hz rTMS in the M1 area on the lesion side can effectively improve the pain, anxiety and depression states of patients with CPSP.