Using magnetic stimulation to treat chronic neuropathic pain
A Pilot Trial of Longitudinal Repetitive Transcranial Magnetic Stimulation (rTMS) for Chronic Neuropathic Pain
NA · University of California, San Francisco · NCT05593237
This study is testing if a type of magnetic treatment can help people with chronic nerve pain feel better.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 20 (estimated) |
| Ages | 18 Years to 80 Years |
| Sex | All |
| Sponsor | University of California, San Francisco (other) |
| Locations | 1 site (San Francisco, California) |
| Trial ID | NCT05593237 on ClinicalTrials.gov |
What this trial studies
This clinical trial aims to evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in treating chronic neuropathic pain, which is often difficult to manage with existing therapies. The study will recruit 20 patients diagnosed with chronic neuropathic pain and randomly assign them to receive either high frequency or low frequency rTMS over a period of 10 consecutive weekdays. Participants will undergo baseline assessments, including pain level recordings and self-report questionnaires, to monitor their response to the treatment. The trial is conducted at the University of California, San Francisco, utilizing FDA-cleared TMS devices.
Who should consider this trial
Good fit: Ideal candidates for this study are adults aged 18-80 with chronic neuropathic pain lasting longer than six months and currently on stable pain medications.
Not a fit: Patients with acute pain conditions or those who do not meet the criteria for chronic neuropathic pain may not benefit from this study.
Why it matters
Potential benefit: If successful, this treatment could provide a non-invasive alternative for patients suffering from chronic neuropathic pain with fewer side effects than current medications.
How similar studies have performed: Previous studies have shown promising results for rTMS in treating various pain conditions, suggesting potential efficacy in this novel application for chronic neuropathic pain.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Meets Criteria for Chronic Neuropathic Pain (NP): 1. "Pain caused by a lesion or disease of the somatosensory nervous system 2. Intractable pain longer than 6 months after pain onset 3. Baseline VAS score 30-94-mm 4. Currently prescribed pain medication for NP, history of prior medication trials without adequate pain control, or refused treatments for individual reasons 5. Continuous pain in face and/or extremities * Age 18-80 * Any gender and all ethnoracial categories * Stable on chronic pain medications for 4 weeks prior to the study and agreeable to continue throughout the study. These medications include: Tricyclic antidepressants (e.g., nortriptyline, amitriptyline), SNRIs (e.g., duloxetine, venlafaxine), gabapentinoids (e.g., gabapentin, pregabalin), antiepileptics (e.g., valproic acid, carbamazepine, lamotrigine), and daily anti-inflammatories (e.g., meloxicam), among others (as determined by study physician at the time of screening). Note: Medications that are known to increase cortical excitability (e.g., buproprion, maprotiline, tricyclic antidepressants, classical antipsychotics) or to have an inhibitory effect on brain excitability (e.g., antiepileptics, benzodiazepines, and atypical antipsychotics), or any other medications with relative hazard for use in TMS will be allowed upon review of medications and/or motor threshold determination by TMS specialist. * Participants may continue to take as-needed pain medications and record daily usage throughout the experiment * Capacity to provide informed consent * Ability to tolerate study procedures * Successfully complete the screening forms without contraindications Exclusion Criteria: * Neurologic: Dementia, Severe neurocognitive disorder (MoCA \< 22), Severe aphasia, Seizure disorder, certain structural brain lesions (e.g., intracranial mass lesions, hydrocephalus, sequelae of meningitis), or complete paralysis at target site * Psychiatric: DSM Axis I disorder, Suicidal thoughts, prior psychosurgery, prior ECT * Procedural: prior rTMS within 1 year of consent, enrollment in other clinical trial in the past 6 months * TMS contraindications: implanted device; presence of metal in the head, including eyes and ears (excluding dental implants); certain tics; medications or systemic illness that predispose seizure risk * Participants with an unstable physical, systemic, or metabolic disorder (e.g., unstable hypertension, cardiac disease) * Females who are pregnant or nursing * Inability to complete the research study
Where this trial is running
San Francisco, California
- UCSF Medical Center — San Francisco, California, United States (RECRUITING)
Study contacts
- Principal investigator: Julian C Motzkin, MD/PhD — University of California, San Francisco
- Study coordinator: Dennis Lambert
- Email: Dennis.Lambert@ucsf.edu
- Phone: 415-758-1182
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Chronic Neuropathic Pain, Post-Stroke Pain, Trigeminal Neuralgia, Nerve Injury, Spinal Cord Injuries, Pain, Postoperative, Complex Regional Pain Syndromes, Post-herpetic Neuralgia