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Effect of TMS on Neuropathic Pain for Patients With Spinal Cord Injury
Sponsor: Ankara Etlik City Hospital
Summary
Patients will be randomly assigned to three groups using a randomization scheme: active primary motor cortex (M1) rTMS, active anterior cingulate cortex (ACC) rTMS, or sham M1 rTMS. Stimulation will be delivered using a Magstim Rapid2 Magnetic Stimulator (Magstim, Whitland, UK) with figure-of-eight active and sham coils or a double-cone coil, depending on the treatment group. All patients will receive 10 sessions of 5 Hz rTMS over two weeks under physician supervision. Stimulation intensity will be set at 90% of the resting motor threshold (RMT), determined from the contralateral first dorsal interosseous muscle following stimulation of the dominant hemisphere. Each session will consist of 10 trains of stimulation separated by 50-second intervals, delivering a total of 500 pulses. All patients will continue their conventional physical therapy programs throughout the study.
Official title: The Effect of Transcranial Magnetic Stimulation Applied to the Primary Motor Cortex and Anterior Cingulate Cortex on Refractory Neuropathic Pain in Spinal Cord Injury
Key Details
Gender
All
Age Range
18 Years - 65 Years
Study Type
INTERVENTIONAL
Enrollment
39
Start Date
2025-12-15
Completion Date
2027-08-01
Last Updated
2026-11-02
Healthy Volunteers
No
Conditions
Interventions
active rTMS of M1
Patients in the active primary motor cortex rTMS group will receive active rTMS at 5 Hz targeting the M1 area of the lower extremity motor area under medical supervision for a total of 10 sessions over 2 weeks with 8 coil. The stimulation frequency will be 5 Hz, and stimulation intensity will be set at 90% of the resting motor threshold (RMT), determined from the contralateral first dorsal interosseous (FDI) muscle following stimulation of the dominant hemisphere. Each session will consist of 10 trains of 5 Hz stimulation, separated by 50-second inter-train intervals, delivering a total of 500 pulses per session.
sham TMS
Patients in the sham primary motor cortex rTMS group will receive sham rTMS at 5 Hz targeting the M1 area of the lower extremity motor area under medical supervision for a total of 10 sessions over 2 weeks with sham 8-coil. The stimulation frequency will be 5 Hz, and stimulation intensity will be set at 90% of the resting motor threshold (RMT), determined from the contralateral first dorsal interosseous (FDI) muscle following stimulation of the dominant hemisphere. Each session will consist of 10 trains of 5 Hz stimulation, separated by 50-second inter-train intervals, delivering a total of 500 pulses per session.
active rTMS of anterior cingulate cortex
Patients in the active anterior cingulate cortex rTMS group will also receive active 5 Hz rTMS targeting the anterior cingulate cortex for a total of 10 sessions over 2 weeks under medical supervision with double cone coil. The stimulation frequency will be 5 Hz, and stimulation intensity will be set at 90% of the resting motor threshold (RMT), determined from the contralateral first dorsal interosseous (FDI) muscle following stimulation of the dominant hemisphere. Each session will consist of 10 trains of 5 Hz stimulation, separated by 50-second inter-train intervals, delivering a total of 500 pulses per session.
Locations (2)
Ankara Etlik City Hospital
Ankara, Yenimahalle, Turkey (Türkiye)
Gaziler Physical Therapy and Rehabilitation Training and Research Hospital
Ankara, Çankaya, Turkey (Türkiye)