Randomized Double-blind Study Comparing Three Types of Repetitive Transcranial Magnetic Stimulation for Chronic Neuropathic Pain and Brain Changes Using FMRI

What this Trial Is About

Researchers are evaluating the pain relief effects of three different types of repetitive Transcranial Magnetic Stimulation (rTMS) for people with chronic neuropathic pain that has lasted more than a year and has not responded to usual treatments. The study compares classical rTMS, deeper rTMS, and a placebo (sham) stimulation to understand which method may better reduce pain. The trial is randomized and double-blinded to ensure fair comparison among the groups. Participants undergo neurostimulation sessions following a set schedule: one session daily for five days during the first week, then three sessions in the second week, one session in the third week, and two monthly sessions thereafter. The treatment period lasts seven weeks, after which patients are monitored for an additional two weeks. The study uses different coils for stimulation including the B65 coil for classical rTMS, the B70 coil for deeper stimulation, and a sham coil for placebo treatment. During the study, participants record their daily pain levels using a Visual Numeric Scale (VNS) starting one week before treatment begins and continuing throughout the treatment and follow-up periods. Researchers assess pain progression from the start to the end of treatment and examine brain changes using imaging at day 60. Other measures include response rates, quality of life, anxiety and depression symptoms, and changes in use of pain medications. The total study duration for each participant spans approximately nine weeks, including baseline, treatment, and follow-up assessments.

Study of RTMS Analgesic Effect in Chronic Neuropathic Pain,