Study of Repetitive Transcranial Magnetic Stimulation rTMS Over the Primary Motor Cortex to Relieve Neuropathic Pain in Cancer Patients A Double-Blind, Placebo-Controlled, Cross-Over Trial

What this Trial Is About

Researchers are evaluating the use of high-frequency repetitive transcranial magnetic stimulation rTMS on the primary motor cortex M1 to reduce chronic neuropathic pain related to cancer. While rTMS is recognized as a third-line treatment for refractory neuropathic pain, its effects specifically in cancer-related neuropathic pain have not been thoroughly studied. This trial aims to compare active rTMS to a sham inactive control to assess pain relief and other quality of life factors. Participants will undergo a cross-over study design with two main periods five sessions of active rTMS on the primary motor cortex followed by an eight-week washout, then five sessions of sham stimulation, or vice versa. The order of treatments is randomized. Both active and sham stimulations target the same brain site, with the sham serving as a placebo control. This design helps evaluate the effectiveness of rTMS in reducing pain compared to placebo. Throughout the study, participants will be assessed for pain relief, pain intensity, neuropathic symptoms, mood, quality of life, and brain activity using resting-state fMRI before and after treatments. These evaluations include standardized scales such as the Visual Analog Scale VAS for pain, Neuropathic Pain Symptom Inventory, Brief Pain Inventory, and Hospital Anxiety and Depression Scale. Safety and tolerance will also be monitored. Participant involvement spans from initial treatment sessions through follow-up assessments up to seven weeks after starting stimulation.

Efficacy of Repetitive Transcranial Magnetic Stimulation Over the Primary Cortex in Patients With Neuropathic Pain and Cancer