AzTrials
AzTrials

Chronic Widespread PainNCT07212829

The Added Value of Transcranial Direct Current Stimulation (tDCS) During Exercise for People With Chronic Widespread Pain

A study testing Active tDCS and Aerobic exercise in people with Chronic Widespread Pain and Fibromyalgia (FM), run by Vrije Universiteit Brussel at 1 site in Belgium.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Many people with chronic widespread pain (CWP) feel more pain and fatigue after exercise. This makes it hard to stay active. Unfortunately, the investigators do not fully understand why this happens and how to prevent it. Read more about this study

Who is it for?
Ages 18 to 70 yearsHealthy volunteers can take part
Conditions the study is for
Chronic Widespread Pain, Fibromyalgia (FM)
What is being tested?
Active tDCS and Aerobic exercise
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
1 siteBelgium
Study dates
1 Feb 2026to 30 Jun 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Patients
  • Participants in the patient group must meet all of the following criteria:
  • Diagnosis of chronic widespread pain (CWP) or fibromyalgia;
  • Age between 18 and 70 years old;
  • Body mass index (BMI) ≤ 35;
  • Widespread Pain Index (WPI) assessment: the WPI questionnaire (0-19 points) will be used to record the number and distribution of painful body sites. Participants will be classified as having CWP if pain is reported on both sides of the body, above and below the waist, and in the axial skeleton, with pain symptoms lasting ≥ 3 months;
Show all 12Show fewer
  • Stable medication use for at least 1 month prior to study entry.
  • Healthy control group
  • Participants in the healthy control group must meet all of the following criteria:
  • Age between 18 and 70 years old;
  • Body mass index (BMI) ≤ 35;
  • No chronic conditions, such as chronic pain and diabetes.

Who cannot join

  • For both patients and healthy controls, participants will be excluded if they meet any of the following:
  • Current pregnancy or pregnancy within the past 12 months;
  • Contraindications for non-invasive brain stimulation (NIBS), in line with published safety guidelines;
  • History of neurological disorders, including epilepsy (personal or family history), traumatic brain injury, stroke, dementia, or Parkinson's disease;
  • Major medical conditions, including cancer, endocrine or metabolic disorders, urine, genital and cardiovascu-lar diseases (e.g., myocardial infarction, heart failure, arrhythmia, uncontrolled hypertension).
  • Substance abuse.
  • Presence of psychiatric disorders other than depression or anxiety.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Pain in Motion research group contact

+32 497783956

huanyu.xiong@vub.be

Belgium1 site, 1 recruiting
  • VUB

    Jette, 1090

    Pain in Motion research group, PhD, +32 0497783956, Jo.Nijs@vub.be

    Recruiting

Other trials in Belgium

About this study

Official title: Unravelling the Epigenetic Mechanisms of Exercise-induced Pain in Chronic Widespread Pain: DNA Methylation Regulation of the Brain-derived Neurotrophic Factor Expression and Its Modulation by Transcranial Direct Current Stimulation

Many people with chronic widespread pain (CWP) feel more pain and fatigue after exercise. This makes it hard to stay active. Unfortunately, the investigators do not fully understand why this happens and how to prevent it.

The primary goal of this study is to explore the underlying genetic and epigenetic mechanisms of BDNF gene in response to exercise, and investigate if transcranial direct current stimulation (tDCS) during exercise works to improve worsening symptoms response to exercise in people with CWP.

The investigators designed a randomized crossover study and will enroll 60 patients with CWP and 60 healthy controls. Participants will undergo 2 interventions in random order: 1) exercise + active tDCS, and 2) exercise + sham tDCS. Participants will visit the hospital twice with at least one week in between the visits.

Read the detailed description

Many people with chronic widespread pain (CWP), such as those with fibromyalgia, experience increased pain in response to exercise, which discourages continued physical activity. Although abnormal gene expression via epigenetic mechanisms has been implicated in CWP, the underlying mechanisms by which exercise exacerbates symptoms remain unclear. DNA methylation is one way that environmental factors like exercise can alter gene expression, and brain-derived neurotrophic factor (BDNF) plays a central role in both neuroplasticity and pain processing. The investigators hypothesize that aberrant expression of the BDNF gene contributes to post-exercise symptom flares in CWP.

Transcranial direct current stimulation (tDCS) has been shown to modulate neuroplasticity and influence gene expression, making it a promising approach to normalize BDNF regulation during exercise.

In this randomized crossover trial, 60 CWP patients and 60 healthy controls will each undergo two sessions: (1) exercise with active tDCS and (2) exercise with sham tDCS. Each participant will visit the hospital twice, with at least one week between sessions. During each session, participants will receive one bout of submaximal aerobic exercise (20 min), along with a single session of active or sham tDCS (30 min) simultaneously. The order of interventions will be well-balanced and randomly allocated to each participant. We will measure pain intensity, serum BDNF protein levels, and BDNF gene methylation before and after each session. To capture longer-term effects, participants will also complete online symptom assessments at 8 hours, 24 hours, 48 hours, and 7 days post-exercise.

The primary objective of this study is to determine how active versus sham tDCS during exercise influences BDNF expression, DNA methylation patterns, and pain intensity in CWP patients.

The secondary objectives are to 1) compare these tDCS-induced changes between CWP patients and healthy controls; and 2) identify factors that influence tDCS/exercise-induced changes, including baseline BDNF levels, DNA methylation patterns, genetic polymorphisms and Lifestyle variables (e.g., physical activity).

By elucidating the epigenetic regulation of BDNF in exercise-induced pain and evaluating tDCS as a modulatory intervention, this study seeks to identify biomarkers of symptom exacerbation and develop non-pharmacological strategies that enable CWP patients to remain active without worsening their pain.

Being tested
Active tDCS, Aerobic exercise, Sham tDCS
Keywords
BDNF, pain, exercise, DNA methylation
Medical subject headings
Chronic Pain, Fibromyalgia, Pain, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Active tDCSDevice

    tDCS is performed using a monophasic current device. Pairs of silicon sponge sur-face electrodes (35 cm2) are soaked in saline and positioned as follows: the anode is placed over the region of the dorsolateral prefrontal cortex (DLPFC) per the international 10/20 system at point F3 (left DLPFC), and the cathode is placed on the contralateral supraorbital area (FP2 site). For active tDCS, the current is ramped up for 30 seconds until the center electrode reaches a target intensity of 2 mA, then remains for 29 minutes before dropping for another 30s.

  • Aerobic exerciseBehavioural

    Participants will perform a moderate aerobic exercise (AE, known as aerobic power index), using a cycle er-gometer. The exercise intensity is moderate and individually tailored based on each participant's estimated maximum heart rate (HRmax), calculated using the validated formula: HRmax = 211 - (0.64 × age).

  • Sham tDCSDevice

    tDCS is performed using a monophasic current device. Pairs of silicon sponge sur-face electrodes (35 cm2) are soaked in saline and positioned as follows: the anode is placed over the region of the dorsolateral prefrontal cortex (DLPFC) per the international 10/20 system at point F3 (left DLPFC), and the cathode is placed on the contralateral supraorbital area (FP2 site).

    In the sham condition, current is ramped up to 2.0 mA for 30 seconds and then ramped down to 0 mA, with the total session duration matched to the active condition. This procedure was used to mimic the tingling sensa-tions typically experienced at the beginning of stimulation. Participants received identical instructions, session timing, and room setup across conditions.

Study groups in NCT07212829
Study groupRoleWhat they receive
Exercise + active tDCS + patientsExperimentalPatient participants will receive one bout of submaximal aerobic exercise, along with a single session of active tDCS simultaneously.
Receives: Device: Active tDCS; Behavioral: Aerobic exercise
Exercise + sham tDCS + patientsSham comparatorPatient participants will receive one bout of submaximal aerobic exercise, along with a single session of sham tDCS simultaneously.
Receives: Behavioral: Aerobic exercise; Device: Sham tDCS
Exercise + active tDCS + healthy controlsActive comparatorhealthy volunteer participants will receive one bout of submaximal aerobic exercise, along with a single session of active tDCS simultaneously.
Receives: Device: Active tDCS; Behavioral: Aerobic exercise
Exercise + sham tDCS + healthy controlsSham comparatorhealthy volunteer participants will receive one bout of submaximal aerobic exercise, along with a single session of sham tDCS simultaneously.
Receives: Behavioral: Aerobic exercise; Device: Sham tDCS

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain intensity

    Pain intensity is measured using a 0-10 Numeric Rating Scale (NRS), where 0 indicates "no pain" and 10 indicates "the worst pain imaginable".

    Measured: Participants rate their pain at baseline, and 30 minutes after the intervention.

  2. Blood BDNF levels

    Venous blood samples are collected before and after each exercise-tDCS session. Samples are centrifuged, aliquoted, and stored at -80 °C until analysis. Blood levels of brain-derived neurotrophic factor (BDNF) are quantified using a commercially available enzyme-linked immunosorbent assay (ELISA), following the manufacturer's instructions.

    Measured: Blood samples are collected at baseline and 20 minutes after exercise-tDCS session.

  3. BDNF DNA methylation

    Genomic DNA is extracted from whole blood collected at baseline and after the intervention. DNA methylation of the BDNF gene is assessed using bisulfite conversion followed by quantitative analysis of methylation levels at CpG sites within promoter regions previously associated with pain regulation. Methylation levels are expressed as the percentage of methylated cytosines at each CpG site. Changes in DNA methylation are calculated as the difference between post-intervention and baseline values.

    Measured: Blood samples are collected at baseline and 20 minutes after exercise-tDCS session.

Secondary outcomes (6)
  1. Pain intensity

    Pain intensity is measured using a 0-10 Numeric Rating Scale (NRS), where 0 indicates "no pain" and 10 indicates "the worst pain imaginable".

    Measured: Participants rate their pain at immediately, 8 hours, 24 hours, 48 hours, and 7 days after the intervention.

  2. Fatigue

    Brugmann Fatigue Scale (BFS). Fatigue is assessed with the BFS, an 8-item self-report questionnaire (4 mental and 4 physical items; each scored 0-3). Subscale scores range 0-12 (mental; physical), and the total score ranges 0-24; higher scores indicate greater fatigue/rest propensity.

    Measured: Participants rate their fatigue at baseline, and 24 hours, 48 hours, 7 days after the intervention.

  3. Fibromyalgia symptom impact

    Revised Fibromyalgia Impact Questionnaire (FIQR). The FIQR evaluates the overall impact of fibromyalgia on functioning, symptoms, and quality of life. The total score ranges 0-100 (higher = greater disease burden), comprising function (0-30), overall impact (0-20), and symptoms (0-50) after standard weighting; each item is rated 0-10.

    Measured: Participants rate their FIQR at baseline, and 7 days after intervention.

  4. Central sensitization symptoms

    The Central Sensitization Inventory (CSI) is administered to assess symptoms related to central sensitization, such as sensitivity to touch, light, or sound, sleep disturbances, and concentration difficulties. Scores range from 0 to 100, with higher scores reflecting greater symptom severity. Each item is rated 0-4.

    Measured: Participants rate their CSI at baseline.

  5. Pain catastrophizing

    The Pain Catastrophizing Scale (PCS) is used to measure catastrophic thoughts and feelings related to pain, in-cluding rumination, magnification, and helplessness. Each item is rated 0-4. Total scores range from 0 to 52, with higher values indicating stronger pain catastrophizing tendencies.

    Measured: Participants rate their PCS at baseline, and 30 minutes after the intervention.

  6. Anxiety and depression

    HADS consists of two subscales: HADS-A, designed to detect anxious states, and HADS-D, designed to detect de-pressive states. Each subscale consists of 7 items with a 4-point ordinal response format. Scores range from 0 to 21 in each subscale, with higher scores indicating higher levels of anxious or depressive state. Participants an-swer each item thinking of how they felt and/or behaved during the past week.

    Measured: Participants rate their HAD at baseline.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Oct 2025
  2. Study start1 Feb 2026
  3. Primary completion30 Dec 2027 (estimated)
  4. Study completion30 Jun 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07212829
Sponsor's protocol ID
EC-2025-255
Status last verified
Sep 2025
First submitted
1 Oct 2025
Last updated
20 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing Active tDCS and Aerobic exercise in people with Chronic Widespread Pain and Fibromyalgia (FM), run by Vrije Universiteit Brussel at 1 site in Belgium.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 20 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Pain in Motion research group (+32 497783956, huanyu.xiong@vub.be), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain intensity (time frame: Participants rate their pain at baseline, and 30 minutes after the intervention.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Apr 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in