Patients With Neuropathic Pain Due to Peripheral NeuropathyNCT07758348
Investigating Modulation of Neuropathic Pain by Transcranial Magnetic Stimulation: a Multimodal Imaging and Electrophysiological Approach
A study testing repetitive TMS in people with Patients With Neuropathic Pain Due to Peripheral Neuropathy, run by National Taiwan University Hospital.
Trial summary
The proposed project will combine functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to identify neurobiological mechanisms underlying how repetitive transcranial magnetic stimulation (rTMS) applied to the primary motor cortex modulates maladaptive neuroplasticity following neuropathic pain. Read more about this study
- Who is it for?
- Ages 18 to 90 years
- Conditions the study is for
- Patients With Neuropathic Pain Due to Peripheral Neuropathy
- What is being tested?
- repetitive TMS
- Type of treatment
- Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 52 participants
- Where
- No sites listed yet
- Study dates
- Sep 2026to Jul 2030
- Phase
- Interventional
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 90 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 1. Age 18 or older and 90 or younger. 2. Ability to give informed consent. 3. Independent in activity of daily living. 4. Neuropathic pain secondary to peripheral neuropathy (including hereditary neuropathies). The diagnosis of peripheral neuropathy is confirmed by a neurologist, based on clinical symptoms and at least one of the following objective criteria:
- Nerve conduction study: reduced compound muscle action potential (CMAP) or sensory nerve action potential (SNAP) (peroneal nerve: CMAP < 2 mV, tibial nerve: CMAP < 6.1 mV, and sural nerve: SNAP < 5 microV), or prolonged distal motor latencies (> 5.5 ms), or slowing of motor or sensory nerve conduction velocities (< 40 m/s), or prolonged minimal F latencies (> 50 ms) in two or more nerves in the lower limbs.
- Autonomic function test:
- absent sympathetic skin response (SSR); or (ii) reduced R-R interval variability (RRIV) during rest or forced deep breathing, below age-adjusted thresholds (rest/deep breathing: 12%/19% for age 20 ~ 29 years; 6%/9% for age 30 ~ 39 years; 6%/14% for age 40 ~ 49 years; 5%/11% for age 50 ~ 59 years; and 7%/8% for age not less than 60 years).
- Quantitative sensory test: abnormal warm or cold threshold at the foot (warm/cold thresholds: > 38.6 °C /< 27.5 °C for age < 40 years, > 40.1 °C/< 26.7 °C for age 40 ~ 59 years, and > 40.6 °C/< 27.0 °C for age not less than 60 years).
- Skin biopsy: reduced intraepidermal nerve fiber density at the distal leg (< 5.88 fibers/mm for age < 60 years, and < 2.50 fibers/mm for age not less than 60 years).
- 5. Agree not to take caffeine, alcohol, tea and drugs with significant nervous system effects for 48 hours before each study session.
Who cannot join
- 1. Presence of severe systemic diseases, including severe heart disease, severe lung diseases with dyspnea, severe generalized edema, systemic infection, and uncontrolled migraines due to high intracranial pressure.
- 2. Presence of major neurological disorders, including brain tumor, head trauma, and infection or inflammation of the nervous system.
- 3. History of epilepsy or family history of seizure disorder. 4. Presence of neurodegenerative disorders involving the brain or spinal cord. 5. Patients suffering from multiple sclerosis. 6. Individuals with large areas of ischemic scarring. 7. Skin damage or lesions on the area of the body to be stimulated (the head). 8. Presence of psychiatric disorders diagnosed by a psychiatrist that may interfere with the subjective assessment of pain, including (i) major depressive disorder with a PHQ-9 score not less than 20 (indicating a severe episode; Kroenke et al. (2001)); (ii) anxiety disorder with a GAD-7 score not less than 15 (at a severe level; Spitzer et al. (2006)), or (iii) post-traumatic stress disorder with a PCL-5 score not less than 32 (exhibiting frequent flashbacks or hyperarousal symptoms; Zuromski et al. (2019)).
- 9. Individuals with suicidal ideation within the past year. 10. Presence of implanted medical devices such as a cardiac pacemaker, implantable cardioverter-defibrillator (ICD), cochlear implant, implanted neurostimulator, implanted drug delivery pump, spinal or ventricular drainage device, aneurysm clips, or any metallic foreign object in the body, unless these devices are certified as compatible with MRI or TMS.
- 11. Current use of any medication known to lower the seizure threshold. 12. History of sleep disorders during previous TMS sessions. 13. Pregnancy 14. Claustrophobia or any other contraindications to MRI 15. Inability to give informed consent. 16. Drug abuse and alcoholism
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: INVESTIGATING MODULATION OF NEUROPATHIC PAIN BY TRANSCRANIAL MAGNETIC STIMULATION: A MULTIMODAL IMAGING AND ELECTROPHYSIOLOGICAL APPROACH
The proposed project will combine functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to identify neurobiological mechanisms underlying how repetitive transcranial magnetic stimulation (rTMS) applied to the primary motor cortex modulates maladaptive neuroplasticity following neuropathic pain.
Read the detailed description
Neuropathic pain is pain arising from damage or disease of the somatosensory nervous system, affecting up to 10% of the general population. Common causes of neuropathic pain include diabetes, herpes zoster infections, chemotherapy, and trauma. Despite the employment of multi-line pharmacological treatment, 70~80% of neuropathic pain patients still remain refractory. The refractoriness of neuropathic pain may be attributed to the development of maladaptive plasticity in the brain following chronic neuropathic pain. The proposed project will combine functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to identify neurobiological mechanisms underlying how repetitive transcranial magnetic stimulation (rTMS) applied to the primary motor cortex modulates maladaptive neuroplasticity following neuropathic pain. This combined fMRI-EEG approach will not only improve our understanding of mechanisms underlying neuropathic pain, the most suffering symptom in patients with peripheral neuropathy, but also provide non-invasive brain biomarkers that enable us to investigate the neuromodulatory effects of rTMS by (1) exploring how rTMS modulation is linked to changes in the functional connectivity of the motor cortex, (2) assessing rTMS modulation of the excitatory-inhibitory balance and excitability of the brain, and (3) applying machine-learning models to predict neuroimaging and neurophysiological changes by rTMS from baseline brain functional connectivity. Results from the current project will provide a new perspective to promote precision medicine for neuropathic pain, enabling the future exploration of non-invasive therapeutic targets for rTMS.
- Being tested
- repetitive TMS, sham stimulation
- Keywords
- neuropathic pain, Transcranial magnetic stimulation
- Medical subject headings
- Neuralgia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
repetitive TMSDevice
30 trains of TMS pulses delivered at 10 Hz for 10 s (100 pulses/train) with a 20-s intertrain interval, leading to 3000 pulses per session for a total duration of 15 min
sham stimulationDevice
the stimulation coil will be tilted 90 degrees away from the scalp. This orientation ensures that the participant experiences the characteristic clicking sound and physical sensation of the TMS machine without the magnetic field reaching the brain.
| Study group | Role | What they receive |
|---|---|---|
| real repetitive TMS experiment | Experimental | Not described Receives: Device: repetitive TMS |
| sham repetitive TMS experiment | Sham comparator | Not described Receives: Device: sham stimulation |
What is being measured
The primary outcome is the main question the study is designed to answer.
change in neuropathic pain intensity from the baseline
measured by visual analog scale (VAS)
Measured: 2 weeks after the rTMS interventions
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Aug 2026
- Study startSep 2026 (estimated)
- Primary completionJul 2030 (estimated)
- Study completionJul 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Patients With Neuropathic Pain Due to Peripheral NeuropathyStudies of the same condition, open and under way.
- More trials run by National Taiwan University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Single blind
- Who is masked
- Participant
- Enrolment
- 52 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Taiwan University Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Chi-Chao Chao, MD. PhD, Principal investigator, National Taiwan University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07758348
- Sponsor's protocol ID
- 202510105DINB
- Status last verified
- Aug 2026
- First submitted
- 6 Aug 2026
- Last updated
- 11 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes