About this trial
Neuropathic pain is particularly difficult to treat with classic first-line drugs. Neuromodulation techniques using repetitive transcranial magnetic stimulation (rTMS) are useful alternative, but there is a need to improve their analgesic effect.Virtual reality mirror therapy has shown the capacity to alleviate pain and may be easily coupled with rTMS.The present project will investigate in individuals with neuropathic pain the effects of the rTMS coupled with virtual reality mirror therapy.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Clinical symptoms typical of neuropathic pain
Refractory to drug therapies
Lasting for at least 6 months, with a moderate to severe pain intensity (≥4/10 on Visual Analog Scale, VAS) and a stable pain treatment since 1month at least
Having right to health benefits
Disqualifiers
Ferromagnetic components and implanted microprocessors (i.e. cochlear implants)
Drug-resistant or active epilepsy, pacemaker, pregnancy, ongoing depression or personality troubles, and ongoing opioid treatment.
Any other contraindications to MRI scanner (e.g., claustrophobia, etc.).
Trial design
Parallel
Treatments tested in this trial
Repetitive transcranial magnetic stimulation (rTMS)
Other intervention20 minutes of high frequency (20Hz) rTMS.
Mirror therapy using virtual reality
Other interventionactive mirror-based therapy
Mirror therapy using sham mirror
Other intervention20 minutes of sham mirror-based therapy
Treatment groups
Trial outcomes
Primary outcomes
Pain intensity measurement
Averages of the daily visual analogue scale scores (min no pain max pain imaginable) measured during the first week (Week 1) and that measured during the week following the last session (week 9)
Secondary outcomes
Quality of life after treatment
EQ5D scale (min = 0 worst imaginable health condition and max = 100 best health condition imaginable) and Analgesic consumption of Appeal
Spontaneous brain activity
Functional MRI at rest
neuropathic dimension
overall score of the neuropathic pain symptoms inventory (NPSI) (min = 0 no neuropathic pain and max = 100 intensive neuropathic pain)
Adverse events
Nature and number of adverse events
Sponsors and contacts
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