Despite advances in immunomodulatory therapies, many Psoriatic arthritis (PsA) patients experience persistent pain unrelated to clinical active joint inflammation. Recent evidence suggests the Inferior Parietal Lobule (IPL) serves as a neuroimmune hub linking central neural activity with peripheral immune dysregulation. In a prior feasibility study, a single L-IPL-targeted TMS session reduced pain and altered immune signalling in inflammatory arthritis by reducing STAT3 phosphorylation in circulating monocytes. This study builds on those findings by evaluating whether rTMS over 4 weeks can induce sustained immune reprogramming while providing meaningful pain relief.
Adults ≥ 18 years ≤ 75 years
Diagnosis of PsA according to CASPAR (Classification Criteria for Psoriatic Arthritis).
Low disease activity (no more than one joint with clinically active swelling) or remission
Chronic pain for at least 3 months and VAS (Visual Analogue Scale) pain ≥30 mm
Inability to provide written informed consent.
Severe physical impairment (e.g. blindness, deafness, paraplegia) Pregnant, planning pregnancy or breast feeding.
Severe claustrophobia precluding MRI.
Contraindications to MRI (e.g. metal implants/ pacemaker).
NHS Greater Glasgow and Clyde
Lead sponsor
Chief Scientist Office of the Scottish Government
Collaborator