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
- 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 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
Study at a glance
From the registry record, last updated by the sponsor on 11 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- INVESTIGATING MODULATION OF NEUROPATHIC PAIN BY TRANSCRANIAL MAGNETIC STIMULATION: A MULTIMODAL IMAGING AND ELECTROPHYSIOLOGICAL APPROACH
- ClinicalTrials.gov ID
- NCT07758348
- Acronym / sponsor ID
- 202510105DINB
- Keywords
- neuropathic pain, Transcranial magnetic stimulation
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 52 participants (estimated)
- Lead sponsor
- National Taiwan University HospitalUniversity, hospital or other
- Study start
- Sep 2026 (estimated)
- Primary completion
- Jul 2030 (estimated)
- Study completion
- Jul 2030 (estimated)
- First posted
- 11 Aug 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| real repetitive TMS experiment | Experimental | Device: repetitive TMS |
| sham repetitive TMS experiment | Sham comparator | Device: sham stimulation |
Who may qualify
- Ages
- 18 to 90 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- 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:
- 5. Agree not to take caffeine, alcohol, tea and drugs with significant nervous system effects for 48 hours before each study session.
Key exclusion criteria (5 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| repetitive TMS30 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 | Device | real repetitive TMS experiment |
| sham stimulationthe 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. | Device | sham repetitive TMS experiment |
Primary outcome
change in neuropathic pain intensity from the baseline
Time frame: 2 weeks after the rTMS interventions
measured by visual analog scale (VAS)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Aug 2026.
- Individual participant dataSharing planned: Yes
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Chi-Chao Chao, MD. PhD principal investigator
National Taiwan University Hospital
Questions about this trial
What is this clinical trial studying?
A study testing repetitive TMS in people with Patients With Neuropathic Pain Due to Peripheral Neuropathy, run by National Taiwan University Hospital.
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 7 inclusion and 5 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: opening soon, as of the sponsor's last update on 11 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
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 Chi-Chao Chao, MD. PhD (+886-2312-3456 ext. 265340, b1401019@ms17.hinet.net), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
change in neuropathic pain intensity from the baseline (time frame: 2 weeks after the rTMS interventions). 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 11 Aug 2026.