ArticleBMJ open2026
Personalised functional-connectivity-guided neuronavigated high-frequency repetitive transcranial magnetic stimulation for peripheral neuropathic pain: protocol for a multicentre, randomised, double-blind, controlled trial.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPeripheral neuropathic pain (PNP) is common, disabling and frequently refractory to pharmacotherapy. High-frequency repetitive transcranial magnetic stimulation (rTMS) can reduce neuropathic pain but response rates remain variable. Personalised target selection based on functional connectivity may improve analgesic efficacy and help elucidate neurobiological mechanisms. METHODS AND ANALYSIS: This is a prospective, multicentre, randomised, double-blind, controlled superiority trial recruiting 152 adults with PNP (eg, trigeminal neuralgia, postherpetic neuralgia and diabetic neuropathy) across four hospitals. Participants will be randomised 1:1 to (1) personalised functional connectivity guided rTMS delivered with MRI-based neuronavigation or (2) conventional rTMS target selection (traditional 'hotspot' approach) with identical procedures to maintain blinding. The intervention consists of 10 sessions over 2 weeks, 18 min per session, 10 Hz and at 90% resting motor threshold. The primary endpoint is change in pain intensity (visual analogue scale, 0-100 mm) from baseline to the day of the 10th session. Secondary outcomes include Leeds Assessment of Neuropathic Symptoms and Signs, Brief Pain Inventory, Short-Form McGill Pain Questionnaire, Patient Global Impression of Change, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and EuroQol five-dimension questionnaire, assessed at the end of the treatment and at 1-week and 1-month follow-up. Mechanistic measures include blood biomarkers (eg, Brain-Derived Neurotrophic Factor (BDNF), β-endorphin, prostaglandins, Gamma-Aminobutyric Acid (GABA) and glutamate), stool 16S rRNA profiling and resting-state functional MRI. Statistical analyses will follow the intention-to-treat principle. Between-group differences in the primary and secondary endpoints will be evaluated using the analysis of covariance (ANCOVA) and linear mixed-effects models. ETHICS AND DISSEMINATION: The study protocol was approved by the ethics committee of the lead centre, the First Affiliated Hospital, Zhejiang University School of Medicine ((2025C) IIT Ethics Approval No. 027), and the participating site, Hangzhou Normal University Affiliated Hospital (2024-E2-HS-008). The findings of this trial will be submitted for publication in peer-reviewed journals and presented at relevant academic conferences.
trial registrationChinese Clinical Trial Registry: ChiCTR2500104679 (registered 20 June 2025, 'A Clinical Study on the Analgesic Effects of Individualized Localization-Based Repetitive Transcranial Magnetic Stimulation for Neuropathic Pain') and ChiCTR2400094568 (registered 24 December 2024, 'Functional MRI connectivity guided personalised targeting to optimise rTMS treatment efficacy in neuropathic pain conditions'). TRIAL REGISTRATION NUMBER: ChiCTR2500104679.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.