Phantom and blunt pain is a type of peripheral neuropathic pain that is particularly difficult to treat and whose underlying mechanisms are not yet understood. Patients with peripheral neuropathic pain also have lower scores on cognitive function compared to healthy people, which can have a negative impact on everyday life.

Repetitive transcranial magnetic stimulation (rTMS) of primary motor areas of the brain is being developed for the treatment of peripheral neuropathic pain and has shown moderate effects for the treatment of phantom and blunt pain. Newer rTMS coils offer the possibility to stimulate larger brain areas (deep rTMS) which may provide better treatment than conventional coils.

Three sub-studies - The purpose of this study is threefold and the study is therefore divided into sub-studies: In substudy 1, the main objective is to investigate whether the peripheral nervous system is a necessary generator of phantom and/or stump pain in patients with lower extremity amputation undergoing spinal anesthesia; in substudy 2, we want to investigate the analgesic effect of deep rTMS compared to placebo (sham) stimulation in the same patients as in substudy 1; in substudy 3, we want to investigate the effect of deep rTMS on cognition compared to placebo stimulation in the same patients.

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