The Role of Transcranial Magnetic Stimulation and Peripheral Magnetic Field Therapy in Chemotherapy-Induced Peripheral Neuropathy: A Narrative Review

Chemotherapy-induced peripheral neuropathy (CIPN) impairs quality of life and may result in discontinuation of anti-neoplastic therapy. In older patients, CIPN is associated with reduced executive function, more severe pain, comorbidities and polypharmacy. The use of magnetic fields to modulate central and peripheral neurons may offer some benefit for relieving neuropathic pain, with few adverse effects. The evidence of the benefits of using transcranial magnetic stimulation (TMS) or peripheral magnetic stimulation (PMS) in patients with CIPN is evaluated in this narrative review. Improved patient-reported outcomes and more rapid nerve conduction velocities in preliminary trials suggest efficacy in patients with CIPN. The potential for additional, broader applications in CIPN includes biomarkers of progression to chronic neuropathic pain, opioid-sparing benefits, and mitigating associated depression and anxiety. Because magnetic stimulation (MS) is relatively resource intense and time consuming, requiring multiple sessions of therapy, its availability is still limited, and multi-center trials are challenging. Further research with sham-controlled clinical trials, using standardized MS techniques and outcome assessments are needed.