Effect of TMS on Neuropathic Pain for Patients With Sci
The Effect of Transcranial Magnetic Stimulation Applied to the Primary Motor Cortex and Anterior Cingulate Cortex on Refractory Neuropathic Pain in Spinal Cord Injury
Ankara Etlik City Hospital
39 participants
Dec 15, 2025
INTERVENTIONAL
Conditions
Summary
The aim of this study is to evaluate the efficacy of rTMS targeting the anterior cingulate cortex, another stimulation site that may be effective in the treatment of neuropathic pain, and to compare it with motor cortex stimulation.
Eligibility
Inclusion Criteria5
- Patients for whom at least 12 months have passed since the date of the event
- Patients who meet the International Pain Working Group's criteria for central neuropathic pain below the level of the lesion and who have had pain for at least 6 months
- Patients aged 18-65
- Pain not attributable to other causes such as rheumatological diseases or diabetes
- Patients with VAS \> 4 despite maximum dose of pharmacological agents (anticonvulsants, antidepressants, narcotics), exercise and physical therapy agents, taking into account renal function tests and other comorbidities
Exclusion Criteria7
- History of epilepsy
- Metallic implant in the scalp
- Cochlear implant
- Spinal cord stimulator
- Pacemaker
- Presence of psychiatric illness
- Pregnancy
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Interventions
Patients in the active or sham primary motor cortex rTMS group will receive active or 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. 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.
Patients in the active or sham primary motor cortex rTMS group will receive active or 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. 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.
Locations(2)
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NCT07293780