Effect of TMS on Neuropathic Pain for Patients With Sci

February 22, 2026 updated by: Ayse Naz Kalem, Ankara Etlik City Hospital

The Effect of Transcranial Magnetic Stimulation Applied to the Primary Motor Cortex and Anterior Cingulate Cortex on Refractory Neuropathic Pain in Spinal Cord Injury

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.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

39

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Ayse Naz Kalem Ozgen, Specialist
  • Phone Number: +90 0312 797 00 00
  • Email: kalemnaz@gmail.com

Study Locations

  • Turkey (Türkiye)
    • Yenimahalle
      • Ankara, Yenimahalle, Turkey (Türkiye), 06010
        • Recruiting
        • Ankara Etlik City Hospital
        • Contact:
    • Çankaya
      • Ankara, Çankaya, Turkey (Türkiye), 06800
        • Recruiting
        • Gaziler Physical Therapy and Rehabilitation Training and Research Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Patients for whom at least 12 months have passed since the date of the event
  2. 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
  3. Patients aged 18-65
  4. Pain not attributable to other causes such as rheumatological diseases or diabetes
  5. 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 Criteria:

  1. History of epilepsy
  2. Metallic implant in the scalp
  3. Cochlear implant
  4. Spinal cord stimulator
  5. Pacemaker
  6. Presence of psychiatric illness
  7. Pregnancy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: active rTMS primer motor cortex
Device: active TMS
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.
Experimental: rTMS anterior cingulate gyrus
Device: active TMS
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.
Sham Comparator: sham rTMS primer motor cortex
Device: sham TMS
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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
visual analog scale
Time Frame: first day of treatment, at the end of treatment (at 2nd week), 4 week after end of treatment, 12 week after end of treatment
The assessment of pain using a 10 cm visual analogue scale (VAS), separately for daytime and night-time. The assessment will be conducted on a scale of "0 = no pain" to "10 = the most severe pain imaginable".
first day of treatment, at the end of treatment (at 2nd week), 4 week after end of treatment, 12 week after end of treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
neuropathic pain scale
Time Frame: first day of treatment, at the end of treatment (at 2nd week), 4 week after end of treatment, 12 week after end of treatment
first day of treatment, at the end of treatment (at 2nd week), 4 week after end of treatment, 12 week after end of treatment
Beck Depression Scale
Time Frame: first day of treatment, at the end of treatment (at 2nd week), 4 week after end of treatment, 12 week after end of treatment
first day of treatment, at the end of treatment (at 2nd week), 4 week after end of treatment, 12 week after end of treatment
5-point Likert scale
Time Frame: first day of treatment, at the end of treatment (at 2nd week), 4 week after end of treatment, 12 week after end of treatment
It is a 5-point Likert scale to be used for assessing patient satisfaction.
first day of treatment, at the end of treatment (at 2nd week), 4 week after end of treatment, 12 week after end of treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ankara Etlik City Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 15, 2025

Primary Completion (Estimated)

August 1, 2026

Study Completion (Estimated)

November 1, 2026

Study Registration Dates

First Submitted

November 13, 2025

First Submitted That Met QC Criteria

December 7, 2025

First Posted (Actual)

December 19, 2025

Study Record Updates

Last Update Posted (Actual)

February 24, 2026

Last Update Submitted That Met QC Criteria

February 22, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • AEŞH-EK-2025-102

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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