- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02562222
Optimized tDCS for the Treatment of Migraine
Optimizing the Effect of Transcranial Direct Current Stimulation (tDCS) for the Treatment of Migraine
Study Overview
Status
Conditions
Detailed Description
A crossover trial to establish an optimized tDCS protocol will be accomplished. Anodal and cathodal tDCS will be applied over the primary motor cortex (C3 - active and contralateral supra-orbital region - reference) and visual cortex (Oz - active and Cz - reference). Dual tDCS (anodal and cathodal - optimized protocol) will be applied on C3 - active and Oz - active.
Electrical cortical activity will be assessed on 14 migraineurs through: (i) MEP; (ii) MT; (iii) SICI; (iv) ICF; (v) PT and (vi) visual evoked-potential (VEP-habituation). An interval of 48hs between sessions will be taken. The order of the sessions will be randomized and counterbalanced among volunteers by site www.randomization.com.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
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Pernambuco
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Recife, Pernambuco, Brazil
- Recruiting
- Applied Neuroscience Laboratory
-
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Ages: 18-55 years
- Gender: Both
- Presented diagnostic of episodic migraine with or without aura or probably migraine with or without aura according to the criteria for diagnosis of ICHD-III
- Disease duration of at least 12 months
- Without preventive medication for at least 6 months prior to initiation of treatment
Exclusion Criteria:
- Pregnant women;
- Pacemaker;
- History of seizures;
- Metallic implants in the head;
- Patients with clinical evidence of brain injuries;
- Chronic pain associated to others diseases;
- Use of neuroleptic medications
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: anodal tDCS on M1
anodal tDCS on left primary motor cortex
|
The direct electric current will be applied by surface electrodes with 35cm² and composed of rubbers conductive electricity and surrounded by sponges soaked in saline solution. The electrodes position will be performed according the 10-20 international system of marking and the different montages will be realized by distinct applications sites. To stimuli the primary motor cortex the active electrode will be positioned on C3 point and the reference electrode on the contralateral supraorbital region. To visual cortex stimulation, the active electrode will be positioned on the Oz point and the reference on Cz. To duo stimulation, the two electrodes will be considerate actives, stimulating the visual and motor cortex simultaneously. The sham tDCS has already been used in several studies to assess the effect active tDCS and the duration of the current is only 30 seconds. |
Experimental: cathodal tDCS on M1
cathodal tDCS on left primary motor cortex
|
The direct electric current will be applied by surface electrodes with 35cm² and composed of rubbers conductive electricity and surrounded by sponges soaked in saline solution. The electrodes position will be performed according the 10-20 international system of marking and the different montages will be realized by distinct applications sites. To stimuli the primary motor cortex the active electrode will be positioned on C3 point and the reference electrode on the contralateral supraorbital region. To visual cortex stimulation, the active electrode will be positioned on the Oz point and the reference on Cz. To duo stimulation, the two electrodes will be considerate actives, stimulating the visual and motor cortex simultaneously. The sham tDCS has already been used in several studies to assess the effect active tDCS and the duration of the current is only 30 seconds. |
Experimental: anodal tDCS on V1
anodal tDCS on visual cortex
|
The direct electric current will be applied by surface electrodes with 35cm² and composed of rubbers conductive electricity and surrounded by sponges soaked in saline solution. The electrodes position will be performed according the 10-20 international system of marking and the different montages will be realized by distinct applications sites. To stimuli the primary motor cortex the active electrode will be positioned on C3 point and the reference electrode on the contralateral supraorbital region. To visual cortex stimulation, the active electrode will be positioned on the Oz point and the reference on Cz. To duo stimulation, the two electrodes will be considerate actives, stimulating the visual and motor cortex simultaneously. The sham tDCS has already been used in several studies to assess the effect active tDCS and the duration of the current is only 30 seconds. |
Experimental: cathodal tDCS on V1
cathodal tDCS on visual cortex
|
The direct electric current will be applied by surface electrodes with 35cm² and composed of rubbers conductive electricity and surrounded by sponges soaked in saline solution. The electrodes position will be performed according the 10-20 international system of marking and the different montages will be realized by distinct applications sites. To stimuli the primary motor cortex the active electrode will be positioned on C3 point and the reference electrode on the contralateral supraorbital region. To visual cortex stimulation, the active electrode will be positioned on the Oz point and the reference on Cz. To duo stimulation, the two electrodes will be considerate actives, stimulating the visual and motor cortex simultaneously. The sham tDCS has already been used in several studies to assess the effect active tDCS and the duration of the current is only 30 seconds. |
Experimental: anodal tDCS on M1 and cathodal on V1
dual tDCS - anodal tDCS on left primary motor cortex and cathodal on visual cortex
|
The direct electric current will be applied by surface electrodes with 35cm² and composed of rubbers conductive electricity and surrounded by sponges soaked in saline solution. The electrodes position will be performed according the 10-20 international system of marking and the different montages will be realized by distinct applications sites. To stimuli the primary motor cortex the active electrode will be positioned on C3 point and the reference electrode on the contralateral supraorbital region. To visual cortex stimulation, the active electrode will be positioned on the Oz point and the reference on Cz. To duo stimulation, the two electrodes will be considerate actives, stimulating the visual and motor cortex simultaneously. The sham tDCS has already been used in several studies to assess the effect active tDCS and the duration of the current is only 30 seconds. |
Experimental: cathodal tDCS on M1 and anodal on V1
dual tDCS - cathodal tDCS on left primary motor cortex and anodal on visual cortex
|
The direct electric current will be applied by surface electrodes with 35cm² and composed of rubbers conductive electricity and surrounded by sponges soaked in saline solution. The electrodes position will be performed according the 10-20 international system of marking and the different montages will be realized by distinct applications sites. To stimuli the primary motor cortex the active electrode will be positioned on C3 point and the reference electrode on the contralateral supraorbital region. To visual cortex stimulation, the active electrode will be positioned on the Oz point and the reference on Cz. To duo stimulation, the two electrodes will be considerate actives, stimulating the visual and motor cortex simultaneously. The sham tDCS has already been used in several studies to assess the effect active tDCS and the duration of the current is only 30 seconds. |
Sham Comparator: sham tDCS
|
The direct electric current will be applied by surface electrodes with 35cm² and composed of rubbers conductive electricity and surrounded by sponges soaked in saline solution. The electrodes position will be performed according the 10-20 international system of marking and the different montages will be realized by distinct applications sites. To stimuli the primary motor cortex the active electrode will be positioned on C3 point and the reference electrode on the contralateral supraorbital region. To visual cortex stimulation, the active electrode will be positioned on the Oz point and the reference on Cz. To duo stimulation, the two electrodes will be considerate actives, stimulating the visual and motor cortex simultaneously. The sham tDCS has already been used in several studies to assess the effect active tDCS and the duration of the current is only 30 seconds. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes on VAS
Time Frame: through study completion, assessed up to 3 weeks (before and after each section)
|
this scale will be used to measure the patients' pain intensity.
VAS is an important instrument to verify, reliably, the patient's evolution during treatment.
This scale will be used at beginning and end of each period (observation and treatment), before and after each tDCS session.
For the VAS use, pain intensity will be asked to the patient.
0 cm means total pain absence and 10 cm is the level of maximum pain bearable by the patient.
|
through study completion, assessed up to 3 weeks (before and after each section)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes on Visual Evoked Potentials measures
Time Frame: through study completion, assessed up to 3 weeks (before and after each section)
|
volunteers will be invited to sit in a comfortable chair, in a calm and dark room, at 90 cm of distance from computer screen.
It will be asked to fix his right eye visual field on a red point at the center of the screen (the left one will be blindfolded).
Visual stimuli will be a black and White grid pattern, alternating at a frequency of 3.1 Hz.
Electrodes used to record data will be localized on Oz and Fz points according International 10-20 system.
During the test, 600 cortical answers will be recorded.
Data will be collected and recorded in a personal computer, and after, converted to the ".txt" format to futures analysis with MATLAB.
|
through study completion, assessed up to 3 weeks (before and after each section)
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Changes on motor evoked potentials
Time Frame: through study completion, assessed up to 3 weeks (before and after each section)
|
to measure MEP, the intensity of the magnetic stimulator will be adjusted to 120% of rest motor threshold and 10 stimuli will be registered.
For evaluation volunteers will be instructed to sit in a chair and get into a comfortable position.
Initially, single-pulse TMS will be administered over the motor cortex to determine the cortical representation area of the first dorsal interosseous muscle (FDI).
For all evaluations the same figure-eight coil is used, in order to avoid measurement bias.
Amplitude means of evoked potentials will determine the MEP.
|
through study completion, assessed up to 3 weeks (before and after each section)
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Changes on intracortical inhibition
Time Frame: through study completion, assessed up to 3 weeks (before and after each section)
|
to evaluate these variables, subthreshold conditioning stimuli (80% of RMT) and suprathreshold test stimuli (120% of RMT) will be delivered at an inter stimulus intervals (ISI) of 2 milliseconds, to determine the short interval cortical inhibition (SICI).
The Intracortical facilitation (ICF) will be evaluated by the MEP average at an ISI of 10 milliseconds.
Ten stimulus will be applied in each condition (unconditioned pulse, and pairs of stimuli with ISI of 2 and 10 milliseconds).
The order of stimulus delivered will be pseudorandomized and SICI and ICF will be expressed as a percentage of a conditioned stimuli in regarding an unconditioned stimuli.
|
through study completion, assessed up to 3 weeks (before and after each section)
|
Changes on intracortical facilitation
Time Frame: through study completion, assessed up to 3 weeks (before and after each section)
|
to evaluate these variables, subthreshold conditioning stimuli (80% of RMT) and suprathreshold test stimuli (120% of RMT) will be delivered at an inter stimulus intervals (ISI) of 2 milliseconds, to determine the short interval cortical inhibition (SICI).
The Intracortical facilitation (ICF) will be evaluated by the MEP average at an ISI of 10 milliseconds.
Ten stimulus will be applied in each condition (unconditioned pulse, and pairs of stimuli with ISI of 2 and 10 milliseconds).
The order of stimulus delivered will be pseudorandomized and SICI and ICF will be expressed as a percentage of a conditioned stimuli in regarding an unconditioned stimuli.
|
through study completion, assessed up to 3 weeks (before and after each section)
|
Changes from phosphene threshold
Time Frame: through study completion, assessed up to 3 weeks (before and after each section)
|
a 10-cm circular coil was used that has giving a peak magnetic field strength of 2 tesla.
Subjects were asked to wear a blindfold, sit comfortably in a chair and to close their eyes to diminish ambient light.In sagittal line, three points were scored: 2, 3 and 4 cm above the inion.
The single pulse TMS was applied to one of the points scored and the subject was asked to report the presence or absence of a phosphene immediately after stimulation.
The stimulation was repeated ten times at each intensity with a maximum frequency of 0.2 Hz, stimulation was initially applied to 60% of the maximum intensity of the stimulator.
The intensity of stimulation was changed into blocks of 5% to minimum intensity that the subject can perceive the phosphene certainly, five times ten, then this value was set as the PT.
|
through study completion, assessed up to 3 weeks (before and after each section)
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- Optimizing_tDCS_Migraine
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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