Elaboration of a Pre-surgery Mapping Protocol of Primary Motor Cortex, Prior to an Implementation of a Stimulation of Primary Motor Cortex for Patients With Deafferentiation of Brachial Plexus Pain (CCPB)
In the context of an insufficiency of clinical results for cortical stimulation in treatment of brachial plexus post-avulsion pains, one of the possibility for failure is the bad pre-surgery mapping of the area to stimulated bu the usual methods (PEM et fMRI). This purpose of this study is to realise a precise mapping of the primary motor cortex post brachial plexus avulsion.
The principal endpoints is to identify and test the reliability of a muscular marker for which the cortical representation is localized immediately next to the superior member area. Several muscles of cephalic, cervical and chest area will be investigate.
The methods used will be mono-shock transcranial magnetic stimulation (mTMS) and functional MRI.
Concerning mTMS, several methods will be tested: best position on the scalp, realisation of outputs maps with extreme points average method, with mass center method.
Concerning fMRI studies, the above paradigms will be checked: imaginary movements of hand, blow up and down abdomen, eyes winking.
Statistical tests will confirm the best muscle candidate and will permit to evaluate the reliability of the method.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Nantes, France, 44000
- Nantes UH
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- For all groups: informed consent, social insurance
- For group 1 "painful BPA": consulting to the Nantes'UH for pain of BPA, EVA≥4, neurological deficiency partial or total
- For group 2 "painless BPA": EVA<4, neurological deficiency partial or total, matching with group 1 on the neurological deficiency
- For group 3 "Healthy": matching with group 1 on age ±10 years
Exclusion Criteria:
- No informed consent
- Medical history of epilepsy
- Pregnant women
- Contra-indication to MRI
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Painless plexus
Patient with a painless avulsion of brachial plexus
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|
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Active Comparator: Healthy
Healthy volunteers
|
|
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Experimental: Painful plexus
Patient with a painful avulsion of brachial plexus
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
|---|---|
|
Identify the 2 muscles (lateral and medial) lining the representation of superior member according to Penfield's homunculus.
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Spatial coordinates (xyz): calculation of the center of gravity of cortical surface suggestive of a specific muscle, using data acquired during each session.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
|---|---|
|
Evaluation of primary outcome depending on cortical center
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Calculation of cortical center evoking the maximal PEM
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Evaluation of primary outcome depending on the center of cortical area
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Calculation of the center of the cortical area suggestive of a precised muscle
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Evaluation of primary outcome depending on cortical surface
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Calculation of cortical surface suggestive of a precised muscle
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Pain intensity
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Pain intensity by using an visual analogic scale
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Ghost sensations intensity
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Ghost sensations intensity by a questionnaire
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Amplitude of PEM
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calculation of the amplitude of PEM for a precised muscle.
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- BRD 10/2-A
- 2010-A00141-38 (Other Identifier: Afssaps)
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