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RECRUITING Not applicable ClinicalTrials.gov

The Effect of Different rTMS Interventions on Acute Experimental Muscular Pain in Individuals Comorbid With Insomnia

Sponsor: The Hong Kong Polytechnic University • ClinicalTrials.gov ID: NCT07827677

Registry updated: 2026-09-18
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Description

Insomnia exacerbates pain sensitivity and impairs physiological recovery from acute musculoskeletal pain. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising non-invasive neuromodulation intervention to alleviate pain and modulate central sensory processing. However, whether rTMS can effectively mitigate insomnia-induced pain hyperalgesia and accelerate the recovery trajectory of acute musculoskeletal pain remains unclear, as does the optimal neuroanatomical stimulation target. Building upon an established experimental pain model, this randomized, sham-controlled study aims to evaluate the restorative effects of three distinct rTMS interventions - targeting the left primary motor cortex (L M1), the right dorsolateral prefrontal cortex (R DLPFC), and a sham condition - on individuals experiencing insomnia. Following a standardized eccentric exercise protocol to induce muscle soreness, participants will receive three sessions of the allocated rTMS intervention at 0, 24, and 48 hours post-exercise. Pain sensitivity, recovery dynamics, and quantitative sensory testing (QST) metrics will be continuously monitored across the recovery timeframe. The findings from this trial will clarify the therapeutic efficacy of rTMS in modulating acute pain under insomnia states and identify the target-specific mechanisms of cortical stimulation, offering evidence-based non-invasive interventions for musculoskeletal pain management.

Interventions

  • Repetitive transcranial magnetic stimulation (rTMS) on L M1 (Device)
    High-frequency stimulation (10 Hz) will be delivered over left M1 at 90% RMT, consisting of 50 pulses per train, a 25-second inter-train interval, and 30 trains per session, yielding a total of 1500 pulses over 15 minutes.
  • Repetitive transcranial magnetic stimulation (rTMS) on R DLPFC (Device)
    Low-frequency stimulation (1 Hz) will be applied over right DLPFC-rTMS at 90% RMT, with 150 trains of 10 pulses per session, a 2-second inter-train interval, and a total of 1500 pulses over 30 min.
  • Sham repetitive transcranial magnetic stimulation (rTMS) (Device)
    Sham stimulation will be administered using identical parameters but delivered via the sham coil, which reproduces the auditory and somatosensory sensations of active rTMS without inducing cortical stimulation.

Eligibility criteria

Inclusion Criteria: * Adults aged 18 to 60 years * Right hand and foot dominant Exclusion Criteria: * History of any chronic musculoskeletal pain or presence of existing pain during recruitment * Previous major injuries or surgery involving the lower limbs * Sleep disorders other than insomnia * Clinically diagnosed psychiatric disorders * Conditions that preclude safe rTMS or pain testing (e.g., severe head trauma, intracranial hypertension, implanted ferromagnetic devices, history of epilepsy, skin conditions at stimulation sites) * Contraindications to vigorous exercise identified through the physical activity readiness questionnaire (PAR-Q) * Work night shifts or rotating shift schedules * Pregnant

Conditions

Insomnia Healthy Adult Exercise Induced Muscle Damage Pain Sensitivity Musculoskeletal Pain

Locations

  • The Hong Kong Polytechnic University — Hong Kong, Hong Kong
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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

View Official Record