{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:45:05Z","timestamp":1777769105167,"version":"3.51.4"},"reference-count":73,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["32271105"],"award-info":[{"award-number":["32271105"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["nyaspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann NY Acad Sci"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Exercise and primary motor cortex (M1) stimulation may alleviate pain by enhancing the endogenous pain\u2010inhibitory system, with its efficacy assessed through conditioned pain modulation (CPM). This study examined whether combining exercise with M1\u2010targeted transcranial electrical stimulation enhances CPM more effectively than either intervention alone. Two randomized, sham\u2010controlled experiments were conducted. In Experiment 1 (\n                    <jats:italic>N<\/jats:italic>\n                    = 70), participants completed a 3\u2010min isometric handgrip exercise or quiet rest. In Experiment 2 (\n                    <jats:italic>N<\/jats:italic>\n                    = 140), participants received 20 min of M1\u2010targeted transcranial random noise stimulation with direct current offset (tRNS + DC\u2010offset) or sham stimulation, followed by either exercise or rest. CPM was assessed at baseline, immediately after, and 30 min post\u2010intervention. Results showed that exercise alone did not significantly enhance CPM efficacy. In contrast, M1\u2010targeted tRNS + DC\u2010offset significantly enhanced CPM efficacy at both post\u2010intervention time points. Critically, individuals with low baseline CPM showed greater benefits from the combination of tRNS + DC\u2010offset and exercise compared to either exercise alone or tRNS + DC\u2010offset alone, particularly at 30 min post\u2010intervention. These results highlight the potential of combining motor cortex stimulation with exercise to optimize endogenous pain inhibition, particularly as a personalized, nonpharmacological intervention for individuals with impaired pain modulation.\n                  <\/jats:p>","DOI":"10.1111\/nyas.70178","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T14:32:09Z","timestamp":1766586729000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Isometric Exercise Combined With Transcranial Electrical Stimulation Improves Conditioned Pain Modulation"],"prefix":"10.1111","volume":"1556","author":[{"given":"Yinglin","family":"Guan","sequence":"first","affiliation":[{"name":"School of Psychology Shenzhen University  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinxin","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Psychology Shenzhen 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