An Exploration of the Neuroplasticity of Endogenous Analgesia in Health and Chronic Pain
Condition: Fibromyalgia
MeSH terms: Fibromyalgia; Chronic Pain
Study type: Interventional

Summary: 
      Transcranial magnetic stimulation (TMS) is a neurophysiological tool for studying cortical
      functions, and in addition, has an analgesic therapeutic effect whose underlying mechanism is
      unknown. The proposed research will use TMS in conjunction with brain imaging and
      electrophysiology to examine cortical plasticity and connectivity modifications induced by
      repetitive TMS (rTMS) targeted to affect cortical regions associated with endogenous
      analgesia (EA). This will be carried out in both healthy and chronic pain (fibromyalgia)
      states. rTMS analgesic intervention, targeted to the motor cortex (M1) will be preceded and
      followed by structural and functional magnetic resonance imaging (fMRI), and Diffusion Tensor
      Imaging (DTI). This will be done in order to examine alterations of cortical and brainstem
      mechanisms involved in EA and to investigate connectivity changes between cortical and
      sub-cortical regions of the EA networks. The latter as well as EA efficiency and pain-related
      personality variables will be used to assess individual differences in neuroplasticity within
      the EA systems in both healthy subjects and chronic pain patients.
    

Detailed description: 
      Transcranial magnetic stimulation (TMS) is a neurophysiological tool for studying cortical
      functions, and in addition, has an analgesic therapeutic effect whose underlying mechanism is
      unknown. The proposed research will use TMS in conjunction with brain imaging and
      electrophysiology to examine cortical plasticity and connectivity modifications induced by
      repetitive TMS (rTMS) targeted to affect cortical regions associated with endogenous
      analgesia (EA). This will be carried out in both healthy and chronic pain (fibromyalgia)
      states. rTMS analgesic intervention, targeted to the motor cortex (M1) will be preceded and
      followed by structural and functional magnetic resonance imaging (fMRI), and Diffusion Tensor
      Imaging (DTI). This will be done in order to examine alterations of cortical and brainstem
      mechanisms involved in EA and to investigate connectivity changes between cortical and
      sub-cortical regions of the EA networks. The latter as well as EA efficiency and pain-related
      personality variables will be used to assess individual differences in neuroplasticity within
      the EA systems in both healthy subjects and chronic pain patients .
    

Intervention name(s): active repeated transcranial magnetic stimulation; 'sham' repeated transcranial magnetic stimulation
Intervention type(s): Device; Device
Intervention description(s): ten daily sessions with active 10Hz 20 min-long stimulation over the primary motor cortex; ten daily sessions with 'sham' 10Hz 20 min-long stimulation over the primary motor cortex
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Participant)
Primary purpose: Basic Science