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MigraineNCT07841509

The Effect of Remote Electrical Neuromodulation (REN) on Conditioned Pain Modulation (CPM) in Migraine and Fibromyalgia

A study testing Remote Electrical Neuromodulation (REN) device in people with Migraine and Fibromyalgia, run by Theranica at 2 sites in 2 countries.

Recruiting

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

Sites and contacts
Official record
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Trial summary

Migraine and Fibromyalgia (FM) are chronic pain disorders characterized by altered central pain processing and impaired endogenous pain inhibition. FM presents with widespread musculoskeletal pain, fatigue, sleep disturbance, and cognitive symptoms and is strongly associated with central sensitization. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Remote Electrical Neuromodulation (REN) device
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
2 sitesin 2 countries
Study dates
23 Jun 2026to 31 Aug 2027
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults diagnosed with migraine and/or fibromyalgia above 18 years old.
  • For migraine:
  • Has been diagnosed with migraine according to the ICHD-3 diagnostic criteria for migraine
  • Experiencing 6-24 headache days per month
  • Uses up to 1 prescribed preventive medication for migraine
  • Did not make any changes to their migraine medications treatment in the month prior to the study enrollment.
Show all 12Show fewer
  • For Fibromyalgia:
  • Has been diagnosed with FM according to the ACR 2010/6 diagnostic criteria for FM with disease duration for at least 6 months prior to study enrolment.
  • Did not make any changes to their FM medications in the month prior to the study enrollment.
  • Naïve to the Nerivio device.
  • Must be able and willing to comply with the protocol.
  • Provides written informed consent form.

Who cannot join

  • Has an implanted electrical and/or neurostimulation device (e.g., cardiac pacemaker or defibrillator, vagus nerve neurostimulator, deep brain stimulator, spinal stimulator, bone growth stimulator cochlear implant, sphenopalatine ganglion stimulator bladder stimulator, or occipital nerve stimulator).
  • Patients with severe depression.
  • Patients with known epilepsy. Use of any analgesics (OTC or prescribed) 24 hours prior to the study enrollment.
  • Use of Cannabis within 10 days prior to the study enrollment.
  • Use of opioids 2 months prior to the study enrollment.
  • Pregnant or breastfeeding

Trial locations and contacts

2 sites in 2 countries. Contact the study team or a site near you to ask about taking part.

Dagan Harris, PhD contact

+972723909763

daganh@theranica.com

Yara Asmar, BSc contact

+972723909763

yaraa@theranica.com

2 sites in 2 countries

United States1 site, 1 recruiting
  • Theranica Bio-Electronics Inc

    Bridgewater, New Jersey, 08807

    Alit Stark Inbar, PhD, Alitsi@theranica.com

    Not yet recruiting

Other trials in United States

Israel1 site, 1 recruiting
  • Rambam Health Care Campus

    Haifa

    Yelena Granovsky, PhD, +97247772065

    Yelena Granovsky, PhD

    Recruiting

Other trials in Israel

About this study

Official title: A Randomized, Double-blind, Placebo-controlled, Study to Evaluate the Effect of a REN Wearable Device on Conditioned Pain Modulation (CPM) in Patients With Migraine and/or Fibromyalgia

Migraine and Fibromyalgia (FM) are chronic pain disorders characterized by altered central pain processing and impaired endogenous pain inhibition. FM presents with widespread musculoskeletal pain, fatigue, sleep disturbance, and cognitive symptoms and is strongly associated with central sensitization. Migraine similarly involves dysfunction of central inhibitory and descending pain modulation, with evidence of abnormal cortical excitability, impaired sensory habituation, and alterations in pain-related evoked potentials.

Conditioned Pain Modulation (CPM) is a measure of the body's endogenous pain-inhibitory mechanism, based on the phenomenon whereby the pain evoked by one painful stimulus (the test stimulus) is reduced by the concurrent application of a second, remote nociceptive stimulus (the conditioning stimulus). It is widely regarded as a proxy for the function of descending pain-modulatory pathways.

Read more

CPM is used as an experimental biomarker of descending pain inhibition across chronic pain conditions, including fibromyalgia and migraine. Studies consistently demonstrate reduced inhibitory responses in both migraine and fibromyalgia compared with healthy controls, indicating a robust deficit in descending pain modulatory systems. Combining a contact heat test stimulus (TS) with a cold pressor conditioning stimulus (CS) is a widely used and validated CPM paradigm.

Nerivio, a Remote Electrical Neuromodulation (REN) device, is a non-invasive, non-pharmacological therapy indicated for the acute and preventive treatment of migraine. The REN device is worn on the upper arm and delivers peripheral electrical stimulation to activate CPM-related descending inhibitory pathways and reduce migraine pain. This distal stimulation approach is designed to activate CPM-related circuits by recruiting brainstem pain-regulatory centers and modulating central nociceptive processing.

This randomized, double-blind, placebo-controlled trial is designed to assess the effect of a single REN session on CPM and cortical pain processing in adults with migraine or fibromyalgia. Using a standardized CPM induction protocol, the study will evaluate changes in behavioral CPM responses, before, during, and after REN vs. sham stimulation in patients with migraine or fibromyalgia. This study aims to clarify whether REN enhances descending pain inhibition and pain processing in populations with impaired endogenous pain modulation.

Read the detailed description

The Nerivio device is a prescription use, self-administered device for use in the home environment for the acute and/or preventive treatment of migraine above the age of 8 years old. It is a wireless, wearable, battery-operated stimulation unit controlled by a smartphone software application.

The study hypothesis is that the REN wearable can induce the CPM mechanism, leading to a reduced pain response to a painful stimulus, and that the reduced pain response following REN stimulation will be larger than following Placebo (sham) stimulation, similar to the standard CPM response demonstrated by exposure to cold water. The placebo device will be identical to the active Nerivio device in its appearance and administration, differing only in the electrical waveform which is designed to activate the CPM mechanism (REN) or not (Placebo).

Pain levels will be measured using standard Numeric Rating Scale (NRS) between 0 and 10.

This hypothesis will be tested using Active or Sham devices as the Conditioned Stimuli (CS), with a heat stimulus serving as the Test Stimulus (TS) for pain induction.

Where:

TS is a painful stimulation (heat on the arm) P1 is the pain response to TS (baseline P2 is the pain response to TS following a standard CS (hand in cold water) P5 is the pain response to TS 15 minutes following a REN treatment (stimulation on the upper arm) CPM1 is the difference between TS pain response following the standard CS (cold water) and the pain response to the TS alone (CPM1 = P2-P1) CPM4 is the difference between TS pain response following the standard CS (cold water) and the pain response following 15 minutes after REN treatment (CPM4 = P5-P1)

The study hypothesis is that REN will lead to a larger CPM response than the placebo stimulation. That is, the CPM response following REN (CPM4 REN = P5 REN - P1 REN) will be larger than the CPM response following Placebo (CPM4 Placebo = P5 Placebo - P1 Placebo), relative to the standard CPM response to cold water in each arm:

H0: (CPM4 REN - CPM1 REN) - (CPM4 Placebo - CPM1 Placebo) = 0 H1: (CPM4 REN - CPM1 REN) - (CPM4 Placebo - CPM1 Placebo) ≠ 0

In other words:

H0: (P5 REN - P2 REN) - (P5 Placebo - P2 Placebo) = 0 H1: (P5 REN - P2 REN) - (P5 Placebo - P2 Placebo) ≠ 0

The analysis will compare REN and Placebo as CS across various TS, relative to the effect of cold water - a defined, well-established CS for CPM induction.

The study design includes the following:

Setting of Test Stimulus (TS): Participant will undergo thermal pain stimulus. 10-second thermal stimulus will be applied to the volar forearm using a contact thermode. Pain levels from repeated TS applications will be collected using NRS. This pain level is defined as P1.

Standard Conditioning Stimulus (Cold water hand immersion). TS will be applied under the presence of Conditioning Stimulus (CS). The participant's hand \& wrist will be immersed for up to 30 seconds in a plastic container filled with cold water at 8-10°C. Pain levels from repeated TS applications will be collected using NRS. This pain level is defined as P2. CPM1 will be calculated by comparing P2 to P1.

Randomization procedure

Following completion of the baseline CPM assessment, qualified participants will be randomized to either:

  • Active REN group
  • Placebo (Sham) group

A break of 15 minutes will be taken prior to starting the treatment phase to eliminate the CPM effect by cold water.

A device (REN or Placebo) will serve as the Conditioning Stimulus, and treatment will be conducted for 45 minutes. TS will be applied and pain levels will be collected using NRS from repeated TS applications at mid treatment (P3; 20 minutes into treatment), end of treatment (P4; 40 minutes into treatment), and post treatment (P5; 15 minutes following the end of the treatment).

Interim analysis will be performed following the recruitment of 40 participants,

Being tested
Remote Electrical Neuromodulation (REN) device
Keywords
Remote Electrical Neuromodulation, Nerivio
Medical subject headings
Migraine Disorders, Fibromyalgia

What participants receive

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

  • Remote Electrical Neuromodulation (REN) deviceDevice

    Also called Nerivio

    Nerivio is a Remote Electrical Neuromodulation (REN) Device. It is approved for the acute and/or preventive treatment of migraine from the age of 8 and above.

Study groups in NCT07841509
Study groupRoleWhat they receive
Active REN treatmentActive comparatorThis arm will use the active REN device as the Conditioned Stimulus (CS) to the thermal Test Stimulus (TS) that will be applied at 20, 40, and 60 minutes following the initiation of the treatment with the Active REN device.
Receives: Device: Remote Electrical Neuromodulation (REN) device
Placebo REN treatmentPlacebo comparatorThis arm will use the Placebo device as the Conditioned Stimulus (CS) to the thermal Test Stimulus (TS) that will be applied at 20, 40, and 60 minutes following the initiation of the treatment with the Placebo device.
Receives: Device: Remote Electrical Neuromodulation (REN) device

What is being measured

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

  1. Between-groups (Active vs Placebo) difference in mean change of Conditioned Pain Modulation (CPM) activity from post-treatment (CPM4) to baseline (CPM1), measured by Numeric Rating Scale (NRS, 0-10).

    Difference between the Active and Placebo groups in the mean change of pain levels following Test Stimulus (TS) at 15 minutes post-treatment with the REN wearable as the Conditioned Stimulus (CS) versus pain levels following Test Stimulus (TS) under cold water as Conditioned Stimulus (CS):

    (CPM4 REN - CPM1 REN) - (CPM4 Placebo - CPM1 Placebo) = (P5 REN - P2 REN) - (P5 Placebo - P2 Placebo)

    The pain range is between 0 to 10. CPM4 is the difference between the pain level with REN as CS and pain prior treatment without Conditioned Stimulus (CS). CPM1 is the difference between the pain level with Cold Water as Conditioned Stimulus (CS) and pain prior treatment without Conditioned Stimulus (CS). Thus, the expected value is a negative number and higher number means higher CPM activity.

    Measured: 1 hour

Secondary outcomes (2)
  1. Between-groups difference in mean change of pain levels from post-treatment Test Stimulus (P5) to baseline Test Stimulus (P1), measured by Numeric Rating Scale (NRS, 0-10).

    Difference between the Active and Placebo REN groups in the mean change of pain levels following Test Stimulus at 15 minutes post-treatment with REN as Conditioned Stimulus (CS) and baseline pain levels following Test Stimulus only, without Conditioned Stimulus (CS):

    (P5 REN - P1 REN) vs. (P5 Placebo - P1 Placebo)

    The pain range is between 0 to 10. the higher the number, the higher the pain. The expected value is a negative number and higher number means higher CPM activity.

    Measured: 1 hour

  2. Between-group difference in mean change of pain levels following Test Stimulus (TS) under cold water as Conditioned Stimulus (CS) (P2) to baseline Test Stimulus only (P1), measured by Numeric Rating Scale (NRS, 0-10).

    Difference between the Active and Placebo REN wearable groups (prior randomization) in the mean change of pain levels following Test Stimulus under cold water as Conditioned Stimulus (CS), and baseline pain levels following Test Stimulus only (P2-P1), This comparison will determine the CPM response of the participants PRIOR to randomization.

    CPM1 REN vs CPM1 Placebo = (P2 REN - P1 REN) vs (P2 Placebo - P1 Placebo)

    The pain range is between 0 to 10. the higher the number, the higher the pain. The expected value is a negative number and higher number means higher CPM activity.

    Measured: 15 minutes

Timeline

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

  1. First posted25 Sep 2026
  2. Study start23 Jun 2026
  3. Primary completion1 Aug 2027 (estimated)
  4. Study completion31 Aug 2027 (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
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Model description
A randomized, double-blind, placebo-controlled trial
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07841509
Sponsor's protocol ID
TCH-016
Status last verified
Sep 2026
First submitted
8 Sep 2026
Last updated
25 Sep 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Remote Electrical Neuromodulation (REN) device in people with Migraine and Fibromyalgia, run by Theranica at 2 sites in 2 countries.

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 6 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 25 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States, Israel. 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 Dagan Harris, PhD (+972723909763, daganh@theranica.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Between-groups (Active vs Placebo) difference in mean change of Conditioned Pain Modulation (CPM) activity from post-treatment (CPM4) to baseline (CPM1), measured by Numeric Rating Scale (NRS, 0-10). (time frame: 1 hour). 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 25 Sep 2026.

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