{
  "abstract": "Pain expectancy is a major determinant of pain perception, and identifying effective approaches to modulate expectancy may provide new opportunities for pain intervention. High-frequency repetitive transcranial magnetic stimulation (rTMS) targeting the dorsolateral prefrontal cortex (DLPFC) has been implicated in expectancy-related pain modulation. However, it remains unclear how DLPFC-rTMS influences distinct stages of expectancy processing and how these changes relate to subsequent pain experience. Thirty-three healthy participants completed a randomized, double-blind, sham-controlled crossover study. Participants received real or sham high-frequency DLPFC-rTMS and performed a pain expectancy paradigm before and after stimulation while EEG was recorded. The paradigm dissociated expectancy formation and maintenance under certain and uncertain predictive contexts. Behaviorally, DLPFC-rTMS reduced pain intensity and unpleasantness, accompanied by a reduction in expected pain, and mediation analysis identified an indirect effect through expected pain. At the neural level, DLPFC-rTMS increased contextual cue-evoked P2 responses relative to sham during expectancy formation but reduced anticipatory N1 and contingent negative variation (CNV) responses during expectancy maintenance. During pain experience, laser-evoked N1 responses showed a context-dependent pattern, with greater attenuation under uncertainty. Importantly, mediation analyses identified distinct stage-related indirect associations: stimulation-related changes in contextual P2 responses were linked to subsequent laser-evoked N1 responses, whereas changes in anticipatory CNV and anxiety were jointly associated with subsequent pain ratings. Together, these findings demonstrate that DLPFC-rTMS modulates dynamic expectancy processes across distinct stages of pain anticipation, with formation- and maintenance-related changes linked to different aspects of subsequent pain processing.",
  "abstract_shown": true,
  "affiliations": [
    "Tech X Academy, Shenzhen Polytechnic University, Shenzhen, China",
    "School of Psychology, Shenzhen University, Shenzhen, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Richu Jin"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhouan Liu"
    },
    {
      "affs": [
        1
      ],
      "name": "Jia Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Yinglin Guan"
    },
    {
      "affs": [
        1
      ],
      "name": "Guohui Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Xiaoyun Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Weiwei Peng"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/59fd1e0z37p8c.bib",
  "cited_by": 0,
  "doi": "10.1016/j.neurot.2026.e01107",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13738117/",
  "id": "59fd1e0z37p8c",
  "issns": [
    "1933-7213",
    "1878-7479"
  ],
  "landing_url": "https://doi.org/10.1016/j.neurot.2026.e01107",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2808|Transcranial Magnetic Stimulation Studies"
    ]
  ],
  "openalex": "W7224128357",
  "pdf_url": "https://www.neurotherapeuticsjournal.org/article/S1878-7479(26)00277-1/pdf",
  "pmcid": "PMC13738117",
  "pmid": "42950395",
  "published": "2026-10-28",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/59fd1e0z37p8c.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:09Z",
      "native_id": "PMC13738117",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.neurot.2026.e01107"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2808|Transcranial Magnetic Stimulation Studies",
      "subfield": "neurology"
    }
  ],
  "title": "Prefrontal rTMS modulates dynamic expectancy processes to shape subsequent pain experience",
  "title_text": "Prefrontal rTMS modulates dynamic expectancy processes to shape subsequent pain experience",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:09Z",
  "url": "https://research.draconitic.com/paper/59fd1e0z37p8c",
  "venue": "Neurotherapeutics",
  "versions": []
}