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Comparison of the Efficacy of rTMS and tDCS of the Motor Cortex in Patients With Chronic Neuropathic Pain

Phase 4
Completed
Conditions
Lumbar Radiculopathy
Interventions
Device: active or placebo rTMS or active or placebo tDCS
Registration Number
NCT02030626
Lead Sponsor
Hospital Ambroise Paré Paris
Brief Summary

The present study aims to compare directly the efficacy of two noninvasive neurostimulation techniques : repetitive transcranial magnetic stimulation and transcranial direct electrical current of the motor cortex in patients with chronic lumbar radiculopathy on pain intensity.

Detailed Description

The present study ims to compare directly the efficacy of two noninvasive neurostimulation techniques : repetitive transcranial magnetic stimulation (rTMS) and transcranial direct electrical current (tDCS) of the motor cortex in patients with chronic lumbar radiculopathy on average pain intensity. This will be a sham controlled crossover design : patients will be randomized to receive either active rTMS or tDCS during 3 consecutive days followed by the alternative treatment within 3 weeks apart, or sham rTMS or tDCS during 3 consecutive dats followed by the alternative treatment within 3 weeks apart. The investigator will be blind to the treatment. Assessments will be performed before each treatment, then 1 hour after the end of the third day session, then 2 days and 1 week after the stimulation. Assessments will include pain questionnaires, quality of life, anxiety and depression, catastrophizing and evaluation of treatment effect on experimental pain using Quantitative sensory testing.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
35
Inclusion Criteria

Patients aged more than 18 years and less than 60 years, males of females Lumbosciatica or lumbocruralgia with predominant neuropathic components with DN4 score ≥ 4/10 Chronic pain with an intensity of at least 4/10 Stable analgesic treatment for at least 15 days before inclusion Able to speak and understand French Social security

Exclusion Criteria

Work accident or litigation Contraindication to rTMS (sismotherapy in the preceding month, epilepsia, past head trauma, intracranial hypertension, metallic clip, pace maker, pregnancy or lactation Major depressive episode Intermittent pain Consent refusal Impossible to follow up during the duration of the study Pain more severe than neuropathic pain

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sham rTMS followed by tDCS (or conversely)active or placebo rTMS or active or placebo tDCSPlacebo rTMD followed by placebo tDCS or conversely
active rTMS or active tDCS or placeboactive or placebo rTMS or active or placebo tDCSActive rTMS (10 Hz) of the motor cortex followed by active tDCS (2 mA) of the motor cortex or conversely
Primary Outcome Measures
NameTimeMethod
Comparison of rTMS and tDCS on average pain intensity7 days after 3 days of stimulation

Average pain intensity numerical scales (0-10)

Secondary Outcome Measures
NameTimeMethod
Comparison of rTMS and sham stimulation on average pain intensity7 days after 3 stimulation days

numerical scale for pain intensity (0-10)

comparison of tDCS and sham stimulation on average pain intensityat 7 days after 3 days of stimulation

numerical scales for pain intensity (0-10)

comparison of rTMS and tDCS on current pain1 hour after each stimulation session

pain intensity (right now)1 hour after each stimulation

comparison of rTMS versus tDCS and versus sham on BPI interference7 days after the end of 3 stimulation days

BPI interference scale (0-70)

comparison of rTMS versus tDCS and sham on pain catastrophizing7 days after the last day of stimulation (3 days)

Pain catastrophizing scale (PCS)

comparison of rTMS versus tDCS and sham on anxiety and depression7 days after the end of stimulation sessions

Hospital anxiety and depression scale

comparison of rTMS versus tDCS and sham on neuropathic symptoms7 days after the end of stimulations

Neuropathic pain symptom inventory

comparison of rTMS versus tDCS and sham on thermal testing2 days and 7 days after stimulation days

thermal testing using thermotest on the upper limbs

comparison of safety between rTMS and tDCS and between neurostimulation and shamimmediately after each stimulation, then at 2 days and 7 days

any emerging side effects

comparison of rTMS and tDCS on pain intensity2 days after 3 stimulation days

numerical score (0-10) for pain over the last 24 hours

Trial Locations

Locations (2)

Hôpital Ambroise Paré

🇫🇷

Boulogne Billancourt, France

Hôpital Henri Mondor, APHP

🇫🇷

Créteil, France

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