Neuropathic pain is a complex and demanding medical condition that is often difficult to treat. Regardless the cause of impairment, lesion or damage of the nervous system can lead to neuropathic pain, such as Phantom Limb Pain (PLP). No treatment has been found widely effective for PLP but guided plasticity therapies have shown the least severe side effects in comparison to pharmacological or surgical interventions. Phantom Motor Execution (PME) is a guided-plasticity intervention that has

more »

... promising results alleviating PLP. The Stochastic Entanglement hypothesis suggests an origin for neuropathic pain resulting from sensorimotor impairment. In this study we build on this hypothesis to investigate the efficacy of enhancing PME interventions with the addition of sensory training. We refer to this concept as Mindful SensoriMotor Therapy (MiSMT), that in this study we further complement with non-invasive brain modulation, specifically transcranial Direct Current Stimulation (tDCS), for the treatment of neuropathic pain because of disarticulation or peripheral nerve injury.Methods and analysis This single-arm clinical trial investigates the efficacy MiSMT and tDCS as a treatment of neuropathic pain resulting from highly impaired extremity or peripheral nerve injury in eight participants. The study consists of 15 sessions of MiSMT with anodal tDCS in the motor cortex, pre- and post-treatment assessments, and follow-up sessions. The primary outcome is the change in pain intensity using the Pain Rating Index between the first and last session. Ethics and dissemination The study is performed under approval of the governing ethical committee in Sweden (approval number 2020-07157) and in accordance with the Declaration of Helsinki. Trial Registration Number NCT04897425