Эффект различных интервенций с использованием транскраниальной магнитной стимуляции (rTMS) на острую экспериментальную мышечную боль у пациентов с коморбидной бессонницей

Краткое описание

Бессонница усиливает чувствительность к боли и ухудшает физиологическую регенерацию от острой мышечно-скелетной боли. Повторяющаяся транскраниальная магнитная стимуляция (rTMS) emerged as a promising non-invasive neuromodulation intervention to alleviate pain and modulate central sensory processing. Однако, 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.