The purpose of this study is to compare the analgesic effectiveness of two motor cortex neurostimulations (tDCS and rTMS) and the trans-spinal neurostimulation (tsDCS ) in the algoneurodystrophy.
* Entry into the study : After informed consent, patients will be randomised into three groups : tDCS, rTMS, tsDCS. The physician responsible for conducting neurostimulation sessions will make the randomization via an interactive web response system (IWRS). * Baseline : Participants, will record on a book, a daily Visual Numeric Scale(VNS) of Pain Intensity for 1 month. * The beginning of the treatment : after the baseline, sessions of neurostimulation will begin. Sessions of neurostimulation will have a decreasing rhythm. Five sessions per week during the two first weeks, two sessions per week during the third week, one session during the fourth week and then two sessions per month for four months. * After the end of neurostimulation sessions, patients will be followed for 1month. Throughout their participation in the study, patients will complete their VNS report book (1month of baseline before the treatment, 3 months during neurostimulation, 1 month after neurostimulation). Patients will have 5 evaluation examinations: * The first, one just before the beginning of the neurostimulation, * The second, 1 month after the beginning of neurostimulation * The third, 3 months after the beginning of neurostimulation * And the last one, 1 month after the end of neurostimulation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
36
Centre de la douleur, CHU Grenoble Alpes
Grenoble, Isere, France
Service de Physiologie - Explorations Fonctionnelles, Hôpital Henri Mondor
Créteil, Île-de-France Region, France
The Visual numeric scale of pain between the three groups
Time frame: Baseline to 1 month
The Clinical Global Impression scale (CGI) between the three groups
Time frame: Baseline, 3 months after the beginning of the treatment (day 90), and 1 month after the end of the treatment (Day 180)
The SF12 quality of life questionnaire between the three groups
Time frame: Baseline, 3 months after the beginning of the treatment (day 90), and 1 month after the end of the treatment (Day 180)
The Hospital Anxiety and Depression scale (HAD) between the three groups
Time frame: Baseline, 3 months after the beginning of the treatment (day 90), and 1 month after the end of the treatment (Day 180)
The Neuropathic Pain Symptom Inventory scale (NPSI) between the three groups
Time frame: Baseline, 3 months after the beginning of the treatment (day 90), and 1 month after the end of the treatment (Day 180)
Evolution of the conductance of feet and hands by using Sudoscan
The body conductance will be used to assess the evolution of the Impact of the neurostimulation on the sympathetic nervous system and on the small fiber neuropathy.
Time frame: Baseline, 3 months after the beginning of the treatment (day 90), and 1 month after the end of the treatment (Day 180)
Modifications of the sensori-motor cortical cards by using a MRI
Time frame: Baseline, and 1 month after the end of the treatment (Day 180)
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