REACT
Research type
Research Study
Full title
Rewiring the Brain-Immune Axis for Chronic Pain using Transcranial Magnetic Stimulation in Psoriatic Arthritis.
IRAS ID
363491
Contact name
Flavia Sunzini
Contact email
Sponsor organisation
Research & Innovation NHS GGC
Clinicaltrials.gov Identifier
NA, NA
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Psoriatic arthritis (PsA) is a type of inflammatory arthritis that affects people with personal or family history of psoriasis. Even when inflammation is well controlled with current advanced treatments, up to a third of patients continue to experience high levels of pain that impact daily life. This persistent pain may be partly caused by how the brain and immune system interact, rather than joint pathology alone.
This research study, called the REACT study, is designed to explore how non-invasive, NHS-approved brain stimulation affects the immune system in people with PsA, and how it might help relieve pain. The study uses a safe and approved technique called repetitive transcranial magnetic stimulation (rTMS), which uses magnetic pulses applied to the scalp to non-invasively and gently stimulate specific areas of the brain involved in pain processing and immune regulation. TMS is not electroconvulsive therapy; TMS is non-invasive and currently safely employed to treat severe depression worldwide.
In this study, 40 people with PsA and ongoing pain will be randomly assigned to receive rTMS either over the left inferior parietal lobule (a brain region involved in both pain and immune responses) or over the centre of the head (a control site). Participants will attend 13 study visits over approximately 8 weeks, during which they will undergo 12 TMS sessions, a single brain MRI scan, blood tests, and complete questionnaires on pain, mood, fatigue, and daily functioning.
The main aim of the study is to see whether stimulating the brain can reduce certain immune signals linked to inflammation. The researchers will also assess whether this brain-based treatment leads to improvements in pain and quality of life.
This research may help to identify a new, non-drug approach for managing pain in PsA and improve our understanding of how the brain and immune system interact in chronic inflammatory conditions.
REC name
London - London Bridge Research Ethics Committee
REC reference
25/PR/1789
Date of REC Opinion
30 Jan 2026
REC opinion
Favourable Opinion