- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04936646
Study of rTMS Analgesic Effect in Chronic Neuropathic Pain, (NEUROSTIM)
December 20, 2022 updated by: University Hospital, Grenoble
Randomized Double-blind Study of rTMS Analgesic Effect in Chronic Neuropathic Pain. Comparison Between Three Groups: Motor Cortex Stimulation by the Classic Coil B65, Deeper Stimulation by the Coil B70 and Placebo Stimulation. Analysis of Long-term rTMS-induced Brain Changes Using fMRI.
The purpose of this study is to compare the analgesic effectiveness of three modes of repetitive Transcranial Magnetic Stimulation (rTMS) in chronic neuropathic pain:
- Classical rTMS stimulation
- Deeper rTMS stimulation
- Sham rTMS stimulation
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Conduct of study:
- Entry into the study: After informed consent, patients will be randomised. The physician responsible for conducting neurostimulation sessions will make the randomization via an interactive web response system (IWRS). Only this physician will have the knowledge of the group allocated to the patient.
- Baseline : Patients, will record on a diary form, a daily Visual Numeric Scale(VNS) of Pain Intensity for 1 week.
- Treatment sessions: after the baseline, sessions of neurostimulation will begin for seven weeks.
- After the end of neurostimulation sessions, patients will be followed for 2 weeks.
- Throughout their participation in the study, patients will plot on a diary form their daily VNS.
Study Type
Interventional
Enrollment (Anticipated)
45
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 Contact
- Name: Hasan HODAJ, MD
- Phone Number: 33 04-76-76-52-13
- Email: HHodaj@chu-grenoble.fr
Study Locations
-
-
Isère
-
Grenoble, Isère, France, 38043
- Recruiting
- Centre de la douleur, CHU Grenoble Alpes
-
Contact:
- HODAj Hasan, MD
-
-
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
16 years to 78 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patient's written consent
- Affiliated with social security system
- Male or female, suffering for more than a year from unilateral refractory neuropathic pain: hemi-body, upper limb, lower limb and facial chronic pain.
- Patient whose analgesic treatment, is stable for at least 1 month.
- Patient not responding to conventional treatments
- Prescreening EVN >3
Exclusion Criteria:
- History of drug addiction, epilepsy, cranial trauma
- History of psychiatric disorder
- Patients previously treated with rTMS
- Patient with intracranial ferromagnetic material or implanted stimulator
- New treatment for less than one month
- Pregnant or Breastfeeding woman
- Patient who does not understand the study protocol
- Persons who are protected under the act.
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: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Classic rTMS Stimulation using the B65 Coil
|
The rTMS protocol consist of one session per day for five days during the first week, then three sessions the second week and then one session the third week, followed by two monthly sessions.
|
Experimental: Deeper rTMS Stimulation using the B70 Coil
|
The rTMS protocol consist of one session per day for five days during the first week, then three sessions the second week and then one session the third week, followed by two monthly sessions.
|
Sham Comparator: control group with a sham stimulation using a sham coil
|
The rTMS protocol consist of one session per day for five days during the first week, then three sessions the second week and then one session the third week, followed by two monthly sessions.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evolution of Pain.
Time Frame: Pain progression will be assessed from week 1 (before treatment) to week 7 (end of treatment)
|
Comparison between the 3 groups of the evolution of the weekly value of the Visual Numeric Scale (VNS): The patient will raise his pain level on a follow-up diary each day.
The VNS average will be calculated for each week.
The NSV is a 10-point scale, ranging from 0 (worse) to 10 (better).
|
Pain progression will be assessed from week 1 (before treatment) to week 7 (end of treatment)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assesment of Potential Changes in Sensory-motor Cortical Maps Induced by rTMS
Time Frame: Day 60 from the beginning of rTMS treatment compared to baseline.
|
Comparison between the 3 groups of changes in sensory-motor cortical maps using Functional magnetic resonance imaging (FMRI).
|
Day 60 from the beginning of rTMS treatment compared to baseline.
|
Rate of Responding Patients.
Time Frame: week 7 compared with baseline
|
Comparison between the 3 groups of the rate of responding patients.
Responding patients is defined by a 30% reduction in pain intensity assessed with VNS.
|
week 7 compared with baseline
|
Assessment of Overall Patient Improvement.
Time Frame: Day 30 and day 60 from the beginning of rTMS treatment compared to baseline
|
Comparison between the 3 groups of the overall patient improvement using the Clinical Global Impression of Change scale (CGI).The CGI is a 7-point scale, ranging from 1 (better) to 7 (worse).
|
Day 30 and day 60 from the beginning of rTMS treatment compared to baseline
|
Quality of Life Improvement.
Time Frame: Day 30 and day 60 from the beginning of rTMS treatment compared to baseline
|
Comparison between the 3 groups of the improvement of quality of life using the SF12 (Short Form 12) questionnaire.SF12 includes a mental and social score ranging from 5.89 to 71.97 and a physical score ranging from 9.95 to 70. a high score indicates a better quality of life.
|
Day 30 and day 60 from the beginning of rTMS treatment compared to baseline
|
Evolution of Anxiety and Depressive Traits.
Time Frame: Day 30 and day 60 from the beginning of rTMS treatment compared to baseline
|
Comparison between the 3 groups of the improvement of anxiety and depressive traits using the HADS questionnaire (Hospital Anxiety and Depression Scale).the
HADS score varies between 0 and 42.
zero corresponding to the best score.
|
Day 30 and day 60 from the beginning of rTMS treatment compared to baseline
|
Evolution of Symptomatological Profiles of Neuropathic Pain.
Time Frame: Day 30 and day 60 from the beginning of rTMS treatment compared to baseline.
|
Comparison between the 3 groups of symptomatological profiles of neuropathic pain using NPSI questionnaire (Neuropathic Pain Symptom Inventory).
|
Day 30 and day 60 from the beginning of rTMS treatment compared to baseline.
|
Sympathetic Autonomic System Injury and Small Fiber Neuropathy.
Time Frame: Day 60 from the beginning of rTMS treatment compared to baseline.
|
Comparison between the 3 groups of sympathetic autonomic system injury and small fiber neuropathy using the Sudoscan® device.
|
Day 60 from the beginning of rTMS treatment compared to baseline.
|
Autonomous System Assessement.
Time Frame: Day 60 from the beginning of rTMS treatment compared to baseline.
|
Comparison between the 3 groups of changes in skin tension and conductance during fMRI examination.
|
Day 60 from the beginning of rTMS treatment compared to baseline.
|
Evolution of the use of analgesic treatments.
Time Frame: From baseline to day 60.
|
Comparison between the 3 groups of the evolution of the use of analgesic treatments reported on the diary.
|
From baseline to day 60.
|
Analgesic Response Analysis
Time Frame: From baseline to day 60.
|
Comparison between the 3 groups of the evolution of the weekly EVN average according to the clinical profile of patients
|
From baseline to day 60.
|
Improvement of pain triggered by a stimulus (allodynia).
Time Frame: Day 30 and day 60 from the beginning of rTMS treatment compared to baseline.
|
Comparison between the 3 groups of allodynia improvement.
|
Day 30 and day 60 from the beginning of rTMS treatment compared to baseline.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Hasan HODAJ, MD, CHUGA
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)
July 16, 2021
Primary Completion (Anticipated)
October 1, 2024
Study Completion (Anticipated)
December 1, 2024
Study Registration Dates
First Submitted
June 3, 2021
First Submitted That Met QC Criteria
June 15, 2021
First Posted (Actual)
June 23, 2021
Study Record Updates
Last Update Posted (Estimate)
December 21, 2022
Last Update Submitted That Met QC Criteria
December 20, 2022
Last Verified
December 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 38RC20192
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
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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