- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02970006
Investigating Mechanisms Underlying Spinal Cord Stimulation Efficacy Using Virtual Reality and Full Body Illusion
August 23, 2021 updated by: Vibhor Krishna, Ohio State University
The study hypothesis is that spinal cord stimulation (SCS) combined with virtual leg illumination (provided through a wearable headset (OculusRift, OculusVR, Irvine, CA) and a custom-designed virtual reality leg scenario) will lead to controlled analgesia induction, boosting analgesic effects obtained with standard SCS treatments and will further be associated with changes in the perception of the affected body part.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Epidural spinal cord stimulation (SCS) is an approved treatment for truncal and extremity neuropathic pain.
The mechanisms underlying the efficacy of SCS are unknown.
Recent advances in cognitive neuroprosthetics using virtual reality allow for modulation of body perception and bodily experience, which has also been shown to modulate pain perception.
The present research proposal plans to merge expertise in cognitive neuroprosthetics with neuromodulation techniques in order to test the analgesic properties of the combination of epidural spinal cord stimulation with a new system of multisensory stimulation based on virtual and enhanced reality (i.e., neuro-visual stimulation).
The investigators propose to study this hypothesis prospectively in 25 patients with implanted SCS systems for the treatment of chronic neuropathic pain.
Primary outcomes will be pain reduction (based on subjective, functional and physiological measures) and changes in body perception (based on subjective and objective measures).
The present study will generate a proof-of-concept for the application of neuro-visual stimulation for the treatment of chronic pain and will form the basis for future NIH funding application.
Study Type
Interventional
Enrollment (Actual)
15
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Ohio
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Columbus, Ohio, United States, 43210
- The Ohio Sate University
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age 18-and older at the time of enrollment
- Patients carrying a diagnosis of CPRS type 125 or chronic refractory neuropathic leg pain following FBS4
- Patients who have implanted epidural SCS
- The SCS implantation for at least three months prior to enrollment
- Patients with efficacious SCS as defined by ≥ 50% pain improvement after switching SCS from an OFF state to an ON state ('optimal' stimulation efficacy)
- Patients willing and able to provide informed consent
Exclusion Criteria:
- Patients who are unable to effectively or efficiently communicate for example patients suffering from speech deficits (dysarthria, aphasia) or are non-English speaking.
- Patients with history of prior cranial surgery, significant brain lesions for example intracranial tumors, strokes etc.
- Non efficacious response to SCS <50% pain improvement with optimal stimulation parameters
- Evidence of untreated psychiatric disorders or drugs/alcohol abuse.
- History of seizures
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: neurovisual stimulation
Participants in this study will be adults who have already undergone implantation of SCS for the treatment of their pain conditions.
The study involves no further treatment or intervention.
Subjects will be approached for participation in this study during their routine postoperative clinical visit to the Center for Neuromodulation at the Ohio State University (OSU).All eligible patients will undergo a one-day visit for the virtual reality and full body illusion intervention.
This research will also investigate leg embodiment and leg analgesic effects during SCS integrated with different patterns of virtual leg illumination.
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a new system of multisensory stimulation based on virtual and enhanced reality (i.e., neuro-visual stimulation)
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Average Pain Reduction Post Intervention
Time Frame: At each hour from 1-5 hours post intervention
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10 point Visual Analog pain rating Scale.
Subjective pain perception will be measured by pain ratings on a 10cm visual continuous analog scale (VAS).
Patients rate their pain, ranging from "no pain" (bottom part of the scale) to "the worst imaginable pain" (upper part of the scale) (Huskisson 1974).
The pain reduction will be an average total of the pain scores taken at hours 1, 2, 3, 4, and 5.
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At each hour from 1-5 hours post intervention
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pain Reduction Base on Patient Perception
Time Frame: per minute in each virtual reality condition for 10 minutes in each reality condition.
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Validated questionnaires developed by the collaborators (Swiss Federal Institute of Technology) will be used in order to investigate induced changes in leg perception and ownership.
In particular, we will assess: 1) feeling of ownership towards the leg shown in the virtual reality set-up (leg ownership); 2) tactile sensations felt on the virtual legs, depending on the different conditions of SCS and visual stimulation.
Patients will be asked to indicate how much they agreed with each item using a 7-point colored vertical Likert scale ranging from 0 (complete disagreement, the bottom extreme, red point) to +6 (complete agreement, the top extreme, green point).
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per minute in each virtual reality condition for 10 minutes in each reality condition.
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Vibhor R Krishna, MBBS, Ohio State University
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
October 1, 2016
Primary Completion (Actual)
October 1, 2018
Study Completion (Actual)
November 1, 2019
Study Registration Dates
First Submitted
November 16, 2016
First Submitted That Met QC Criteria
November 17, 2016
First Posted (Estimate)
November 21, 2016
Study Record Updates
Last Update Posted (Actual)
September 20, 2021
Last Update Submitted That Met QC Criteria
August 23, 2021
Last Verified
August 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2016H0202
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
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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