Yossi Zana

Introduction: Safety parameters for non-invasive neuromodulation (NINM) remain scattered across consensus documents that differ in format, units, and scope, so pre-session parameter screening stays error-prone and difficult to audit. Objectives: To describe the NINM Safety Parameter Explorer, a browser-based tool that consolidates safety thresholds for six NINM modalities (e.g., TMS, tDCS, peripheral magnetic stimulation, TENS, transcranial ultrasound, and transcutaneous vagus nerve stimulation) into a single rule engine in which every numeric boundary carries an explicit, auditable provenance classification as literature-derived, literature-anchored, or operational default. Methods and Materials: We encoded the tool’s rule corpus from published international consensus guidelines and peer-reviewed literature (82 modality threshold rules: 29 literature-derived, 36 literature-anchored, 17 operational defaults; complemented by 5 target-site caps for 87 total evaluative rules, alongside 15 informational reference values), then evaluated it in a simulated, automated internal verification suite of 38 example protocols spanning all six modalities and three expected verdicts, with automated static integrity assertions, regression guards, and behavioural and accessibility unit checks, all under a single pinned software version (v1.1.0-beta). Results: All 38 examples agreed with their declared verdicts (19 safe, 8 caution, 11 unsafe), and all static guards and supporting checks passed. Conclusion: The Explorer shows complete internal self-consistency between its rule corpus, engine, and interface, and its per-rule provenance labelling renders safety reasoning transparent and auditable for research and educational use. The tool is an in-silico protocol planning aid; it is not a medical device and is not intended for clinical decision-making or use in humans.

BACKGROUND: Chronic musculoskeletal pain is a prevalent condition associated with significant disability and high healthcare costs. Repetitive Transcranial Magnetic Stimulation (rTMS) has shown promise in pain management, but traditional protocols require daily sessions, posing logistical challenges. Accelerated Theta Burst Stimulation (TBS) offers a more practical alternative by delivering multiple stimulations in a single day. However, its use in chronic pain has not been investigated. OBJECTIVE: This study aims to evaluate the efficacy and safety of an accelerated TBS protocol in reducing pain in individuals with chronic musculoskeletal pain. It also explores neurophysiological mechanisms underlying treatment effects using electroencephalography (EEG). METHODS: A randomized, double-blind, two-phase crossover trial will be conducted with 25 chronic musculoskeletal pain adults. Participants will undergo both active and sham TBS protocols with a minimum one-week washout between phases. Each active session will consist of four 3-minute stimulations targeting the dorsolateral prefrontal cortex (DLPFC) with 600 pulses per session. The primary outcome is pain reduction, and secondary outcomes include changes in EEG oscillations and pressure pain thresholds. Safety will be monitored through reports of adverse effects. RESULTS: This protocol aims to generate preliminary evidence on the feasibility and efficacy of accelerated TBS for chronic musculoskeletal pain. It is expected that active TBS will result in significant pain reduction and modulation of EEG activity, including increased alpha power and reduced theta activity post-treatment. CONCLUSION: This study represents a novel application of accelerated TBS in chronic musculoskeletal pain management. The findings will also contribute to understanding the neuroplastic mechanisms involved in pain modulation through non-invasive brain stimulation.

Background and Objective: Non‐invasive neuromodulation techniques (NIN), such as transcranial Direct Current Stimulation (tDCS) and repetitive Transcranial Magnetic Stimulation (rTMS), have been extensively researched for their potential to alleviate pain by reversing neuroplastic changes associated with neuropathic pain (NP), a prevalent and complex condition. However, treating NP remains challenging due to the numerous variables involved, such as different techniques, dosages and aetiologies. It is necessary to provide insights for clinicians and public healthcare managers to support clinical decision‐making. This umbrella review aims to consolidate existing evidence on the effectiveness of various NIN in managing chronic NP.Databases and Data Treatment: A systematic search was conducted in the PubMed/MEDLINE database, including meta‐analyses of controlled trials comparing NIN techniques with sham interventions for NP treatment. The quality of included studies was assessed using the AMSTAR‐2 tool and the GRADE system, with effect sizes adjusted to the standard mean difference (SMD).Results: The review included 22 meta‐analyses comprising 8151 participants from 214 controlled trials. The most investigated NIN techniques were tDCS and rTMS, with primary targets being the motor cortex and dorsolateral prefrontal cortex. The findings suggest that excitatory protocols, particularly high‐frequency rTMS and anodal tDCS, are effective in reducing pain intensity in individuals with NP. However, the overall quality of evidence was rated low, primarily due to heterogeneity among studies and small sample sizes.Conclusion: NIN techniques show promise in managing NP, with potential benefits in pain reduction. However, further high‐quality research is needed to establish optimal protocols and long‐term effects.Significance Statement: This paper consolidates the evidence regarding non‐invasive neuromodulation for the treatment of neuropathic pain, including differentiating the most effective techniques based on the aetiology of pain, and provides clinicians with easy access to this critical information. It also highlights key aspects that require further research in the field of non‐invasive neuromodulation and neuropathic pain.

BACKGROUND: Chronic pain is one of the most common symptoms of temporomandibular disorders (TMD). Although its pathophysiology is still a challenge, TMD has been associated with changes in central nervous system activity related to pain modulatory capacity. OBJECTIVE: To assess the cortical activity of patients with temporomandibular disorders and chronic pain of myofascial origin using quantitative electroencephalography (qEEG) in different mental states. METHOD: This study consists of a cross-sectional study. Individuals with TMD and chronic pain and healthy controls were evaluated using qEEG in four consecutive conditions, all with closed eyes: 1) initial resting condition; 2) non-painful motor imagery task of hand movement; 3) painful motor imagery task of clenching the teeth; 4) final resting condition. RESULTS: Participants with TMD and chronic pain overall presented decreased alpha power density during baseline at rest, non-painful and painful motor imagery tasks when compared to healthy controls. Furthermore, functional brain connectivity was distinct between groups, with TMD and chronic pain showing lower small-world values for the delta (all conditions), theta (painful and non-painful motor imagery task), and alpha bands (painful motor imagery task), and an increase in the beta band (all conditions). CONCLUSION: These results suggest that TMD and chronic pain could be associated with maladaptive plasticity in the brain, which may correspond to a reduced ability to modify brain activity during different mental tasks, including painful and non-painful motor imagery.

INTRODUCTION: Despite being considered least important for clinical practice in the pyramid of evidence for recommendations, sometimes scientists' expert opinions could help to better understand the summarization of updated publications. OBJECTIVE: To provide a major summarized update about brain imaging and stimulation of the nervous system in health and disease. METHODS: Comprehensive review developed by experts in each subarea of knowledge in neuroimaging and non-invasive stimulation of the nervous system. A team of researchers and clinic experts was invited to present an update on their area of expertise. RESULTS: In basics on brain imaging techniques, we approach general and quantitative electroencephalography, functional magnetic resonance imaging, functional near-infrared spectroscopy, and experimental paradigms in brain imaging studies. Were included associations between transcranial magnetic stimulation and electromyography, electroencephalography, and functional near-infrared stimulation to evaluate brain activity. Furthermore, we showed several actualized central and peripheral neuromodulation techniques. And finally, we presented different clinical and performance uses of non-invasive neuromodulation. CONCLUSION: To our knowledge, this is a major summarized and concentrated update about brain imaging and stimulation that can benefit neuroscience researchers and clinicians from different levels of experience.

INTRODUCTION: Despite being considered least important for clinical practice in the pyramid of evidence for recommendations, sometimes scientists' expert opinions could help to better understand the summarization of updated publications. OBJECTIVE: To provide a major summarized update about brain imaging and stimulation of the nervous system in health and disease. METHODS: Comprehensive review developed by experts in each subarea of knowledge in neuroimaging and non-invasive stimulation of the nervous system. A team of researchers and clinic experts was invited to present an update on their area of expertise. RESULTS: In basics on brain imaging techniques, we approach general and quantitative electroencephalography, functional magnetic resonance imaging, functional near-infrared spectroscopy, and experimental paradigms in brain imaging studies. Were included associations between transcranial magnetic stimulation and electromyography, electroencephalography, and functional near-infrared stimulation to evaluate brain activity. Furthermore, we showed several actualized central and peripheral neuromodulation techniques. And finally, we presented different clinical and performance uses of non-invasive neuromodulation. CONCLUSION: To our knowledge, this is a major summarized and concentrated update about brain imaging and stimulation that can benefit neuroscience researchers and clinicians from different levels of experience.

Review question / Objective: What is the efficacy or effectiveness of NIBS techniques, specifically repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), transcutaneous auricular vagus nerve stimulation (taVNS), percutaneous auricular vagus nerve stimulation (paVNS), and neck vagus nerve stimulation (nVNS), in the control of outcomes associated with COVID-19 in the acute or post-COVID persistent syndrome? Eligibility criteria: Included clinical studies assessed participants with acute or persistent post-COVID-19 syndrome submitted to NIBS interventions, namely transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), transcranial random noise stimulation (tRNS), transcranial magnetic stimulation (TMS), repetitive transcranial magnetic stimulation (rTMS), theta burst (cTBS or iTBS). Studies that used peripheral and spinal cord stimulation techniques were also included. Those included vagus nerve stimulation (VNS), such as transcutaneous auricular (taVNS), percutaneous auricular (paVNS), transcranial random noise stimulation (tRNS) trans-spinal direct current stimulation (tsDCS) and other peripheral electrical stimulation (PES) techniques. Scientific communication, protocol studies, reviews and non-English papers were excluded.

On the basis of experimental data, long-range time representation has been proposed to follow a highly compressed power function, which has been hypothesiz