for people ages 18-80 (full criteria)
at San Francisco, California
study started estimated completion 
by Julian C Motzkin, MD/PhDPrasad Shirvalkar, MD/PHD




A Pilot Trial of Longitudinal Repetitive Transcranial Magnetic Stimulation (rTMS) for Chronic Neuropathic Pain


Eligibility YOU CAN JOIN IF…

Open to people ages 18-80

  • Meets Criteria for Chronic Neuropathic Pain (NP):
    1. “Pain caused by a lesion or disease of the somatosensory nervous system
    2. Intractable pain longer than 6 months after pain onset
    3. Baseline VAS score 30-94-mm
    4. Currently prescribed pain medication for NP, history of prior medication trials without adequate pain control, or refused treatments for individual reasons
    5. Continuous pain in face and/or extremities
  • Age 18-80
  • Any gender and all ethnoracial categories
  • Stable on chronic pain medications for 4 weeks prior to the study and agreeable to continue throughout the study. These medications include: Tricyclic antidepressants (e.g., nortriptyline, amitriptyline), SNRIs (e.g., duloxetine, venlafaxine), gabapentinoids (e.g., gabapentin, pregabalin), antiepileptics (e.g., valproic acid, carbamazepine, lamotrigine), and daily anti-inflammatories (e.g., meloxicam), among others (as determined by study physician at the time of screening). Note: Medications that are known to increase cortical excitability (e.g., buproprion, maprotiline, tricyclic antidepressants, classical antipsychotics) or to have an inhibitory effect on brain excitability (e.g., antiepileptics, benzodiazepines, and atypical antipsychotics), or any other medications with relative hazard for use in TMS will be allowed upon review of medications and/or motor threshold determination by TMS specialist.
  • Participants may continue to take as-needed pain medications and record daily usage throughout the experiment
  • Capacity to provide informed consent
  • Ability to tolerate study procedures
  • Successfully complete the screening forms without contraindications


  • Neurologic: Dementia, Severe neurocognitive disorder (MoCA < 22), Severe aphasia, Seizure disorder, certain structural brain lesions (e.g., intracranial mass lesions, hydrocephalus, sequelae of meningitis), or complete paralysis at target site
  • Psychiatric: DSM Axis I disorder, Suicidal thoughts, prior psychosurgery, prior ECT
  • Procedural: prior rTMS within 1 year of consent, enrollment in other clinical trial in the past 6 months
  • TMS contraindications: implanted device; presence of metal in the head, including eyes and ears (excluding dental implants); certain tics; medications or systemic illness that predispose seizure risk
  • Participants with an unstable physical, systemic, or metabolic disorder (e.g., unstable hypertensioncardiac disease)
  • Females who are pregnant or nursing
  • Inability to complete the research study


  • UCSF Medical Center accepting new patients
    San FranciscoCalifornia94158United States

Lead Scientists

  • Julian C Motzkin, MD/PhD
    Fellow, Neurology, School of Medicine. Authored (or co-authored) 16 research publications
  • Prasad Shirvalkar, MD/PHD
    Associate Professor, Anesthesia, School of Medicine. Authored (or co-authored) 33 research publications. Research interests: Pain Management · Neuromodulation · Deep Brain Stimulation · Headache · Neuropathic Pain · Spinal Cord Stimulation · Post Stroke Pain · Phantom Limb Pain


accepting new patients
Start Date
Completion Date
University of California, San Francisco
Study Type
Expecting 20 study participants
Last Updated