Effects of repetitive transcranial magnetic stimulation versus transcutaneous electrical nerve stimulation to decrease diabetic neuropathic pain

Background/Aims Repetitive transcranial magnetic stimulation and transcutaneous electrical nerve stimulation have been studied repeatedly to reduce diabetic neuropathic pain. The objective of this study was to compare the effects of aerobic training plus one of the treatment therapies on decreasing pain severity in patients with diabetic peripheral neuropathy. Methods A total of 30 patients with diabetic peripheral neuropathy were randomly assigned into two equal groups: group A and group B. Both groups received aerobic training exercises. Group A received repetitive transcranial magnetic stimulation, and Group B received transcutaneous electrical nerve stimulation for 5 consecutive days in 1 week. Outcome measures included pain severity assessment using the Visual Analogue Scale and the serum beta-endorphin levels. Results There was a non-significant difference in pre-treatment (P=0.061) and post-treatment (P=0.652) in the Visual Analogue Scale scores between groups. However, beta-endorphin levels were significantly different between groups in post- (P=0.015) rather than pre-treatment (P=0.459) levels. A significant moderate correlation between beta-endorphin levels and Visual Analogue Scale scores was found in group A (r=-0.6783) at (P=0.008), while it was not significant in group B (r=0.043) at (P=0.883). Conclusions Adding transcutaneous electrical nerve stimulation or repetitive transcranial magnetic stimulation therapies to aerobic training showed similar effects in reducing pain severity in patients with diabetic peripheral neuropathy.