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Efficacy of rTMS on Pain Following Stroke.

Not Applicable
Conditions
Stroke
Interventions
Device: Real-rTMS + Gloreha device
Device: Sham-rTMS + Gloreha device
Registration Number
NCT03354052
Lead Sponsor
University Hospital of Ferrara
Brief Summary

Pain is a common symptom experienced by people following stroke and can significantly interfere with participation in the activities of daily living and adversely affect health-related quality of life. Repetitive Transcranial Magnetic Stimulation (rTMS) promotes the modulation of brain activity and its prolonged and continuous application can effect plastic modification. Combining rTMS with rehabilitation treatment for primary motor cortex activation (using Gloreha® device) may have effect in reducing pain in stroke survivors. This is a pilot randomized control trial to test the effects of rTMS in stroke-related pain rehabilitation, its efficacy on pain, upper limb function, sensory function and autonomy in daily livings activities. Furthermore, we will explore the effects on pressure pain threshold, cortical excitability and EEG recording.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
30
Inclusion Criteria
  • diagnosis of first stroke verified by brain imaging < 6 months
  • pain defined as a constant or intermittent sensory symptom with unpleasant feelings or pain and a minimum score of 3 points on the Numeric Rating Scale (NRS) for pain perception
Exclusion Criteria
  • medical conditions likely to interfere with the ability to safely complete the study protocol
  • cognitive functioning to give informed consent identified by a Mini-Mental Status Examination (MMSE) score ≥ 24/30
  • intracranial metal implants
  • history of seizures or epilepsy
  • severe cardiopulmonary, renal, and hepatic diseases
  • pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Real-rTMS + Gloreha deviceReal-rTMS + Gloreha device-
Sham-rTMS + Gloreha deviceSham-rTMS + Gloreha device-
Primary Outcome Measures
NameTimeMethod
Numeric Rating Scale (NRS)Change measures (weeks: 0,2,6)

Core outcome measure of pain intensity in pain treatments' clinical trials

Secondary Outcome Measures
NameTimeMethod
Short Form McGill Pain Questionnaire (SF-MPQ)Change measures (weeks: 0,2,6)

Assessment of sensory and affective dimensions of typical whole-body pain intensity.

Beck Depression Inventory II (BDI-II)Change measures (weeks: 0,2,6)

Assessment of severity of common depressive symptoms.

Neuropathic Pain Symptom Inventory (NPSI)Change measures (weeks: 0,2,6)

A self-questionnaire specifically designed to evaluate the different symptoms of neuropathic pain.

Pressure Pain Threshold (PPT)Change measures (weeks: 0,2,6)

PPT is measured to test presence of widespread pressure hyperalgesia as sign of abnormal pain processing.

Motor cortex excitability (single pulse TMS)Change measures (weeks: 0,2,6)

Single pulse TMS will be used to study cortical-spinal tract excitability in primary motor cortex (M1).

Erasmus MC modification to the (revised) Nottingham Sensory Assessment - Italian version (EmNSA-I)Change measures (weeks: 0,2,6)

Assessment of sensory function following brain injury.

Fugl-Meyer Assessment - Upper Extremity (FM-UE)Change measures (weeks: 0,2,6)

Assessment of upper limb function.

Barthel Index (BI)Change measures (weeks: 0,2,6)

Scale that measures disability or dependence in activities of daily living in stroke patients.

Electroencephalography (EEG) recordingsChange measures (weeks: 0,2,6)

EEG data will be recorded to test presence of particular brain activity in condition of pain.

Trial Locations

Locations (1)

Ferrara University Hospital

🇮🇹

Ferrara, Italy

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