- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05203770
Adaptations of the Brain in Chronic Pain With Opioid Exposure I
March 15, 2024 updated by: Apkar Apkarian, Northwestern University
This study investigates brain reorganization and behavioral responses in chronic pain with opioid exposure in Chronic Back Pain (CBP).
Study Overview
Status
Active, not recruiting
Conditions
Detailed Description
Chronic back pain (CBP) is the most prevalent chronic pain condition in the US.
Opiates are commonly prescribed to treat CBP; as such, these patients are a primary contributor to the current opioid epidemic.
This study will assess the impact of opioid use on brain anatomy and function in those subjects taking opioids without opioid misuse disorder, as well as those subjects with opioid misuse disorder, relative to those with CBP and are not taking opioids and healthy controls.
This is an observational study, that seeks to establish risk factors and brain biomarkers for opioid misuse disorder and relate brain adaptations to exposure to both opioids and chronic pain.
This study also seeks to determine the impact of opioid use on cognitive, emotional, and motor abilities.
Study Type
Observational
Enrollment (Estimated)
250
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: Elizabeth Yan
- Phone Number: 312-503-6458
- Email: elizabeth.yan@northwestern.edu
Study Locations
-
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Illinois
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Chicago, Illinois, United States, 60611
- Northwestern University
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Chicago, Illinois, United States, 60611
- Shirley Ryan Ability Lab
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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
Yes
Sampling Method
Non-Probability Sample
Study Population
Subjects must be 18 years or older.
Male and Female No racial/ethnic restrictions General health status: generally good health
Description
Inclusion Criteria:
- History of low back pain for a minimum of 6 months daily (prior to screening), meeting the Quebec Task Force Classification System symptom categories I-III;
- Male or female, age equal or greater than 18 years, with no racial/ethnic restrictions;
- Must have a Visual Analog Scale (VAS) pain score ≥ 40 mm (of 100 mm maximum) at the baseline scanning visit (for which 0mm = no pain, and 100 mm = worst pain imaginable);
- Must be able to read and speak English and be willing to read and understand instructions as well as questionnaires;
- Must be in generally stable health;
- Must sign an informed consent document after a complete explanation of the study documenting that they understand the purpose of the study, procedures to be undertaken, possible benefits and potential risks, and are willing to participate;
- Must have, on average ≥ 4/10 units of pain intensity over the course of a 1-2 week period prior to the brain scanning visit;
- Must be willing to complete daily smartphone/computer app ratings;
- Must be on regular opioid or NSAID therapy for at least 3 months prior to randomization (for opioid and non-opioid treatment groups, respectively), which will be up to the clinical investigator's decision.
Exclusion Criteria:
- Low back pain associated with any systemic signs or symptoms, e.g., fever, chills;
- Evidence of rheumatoid arthritis, ankylosing spondylitis, acute vertebral fractures,
- fibromyalgia, history of tumor in the back;
- Other comorbid chronic pain or neurological conditions;
- Involvement in litigation regarding their back pain or having a disability claim or receiving workman's compensation or seeking either as a result of back pain;
- Diagnosis of current major depression or psychiatric disorder requiring treatment, or such a diagnosis in the previous 6 months;
- Beck Depression Inventory II score of >28;
- Use of therapeutic doses of antidepressant medications at unstable doses (i.e., tricyclic depressants,
- SSRIs, SNRIs; low doses used for sleep may be allowed);
- Significant other medical disease such as diabetes, congestive heart failure, coronary or peripheral vascular disease, chronic obstructive lung disease, or malignancy;
- Uncontrolled hypertension;
- Renal insufficiency;
- Current use of recreational drugs or history of alcohol or drug abuse;
- Any change in medication for back pain in the last 30 days;
- High dose opioid prophylaxis, as defined as > 50mg morphine equivalent/day;
- Any medical condition that in the investigator's judgment may prevent the individual from completing the study or put the individual at undue risk;
- In the judgment of the investigator, unable or unwilling to follow protocol and instructions;
- Evidence of poor treatment compliance, in the judgment of the investigator;
- Intra-axial implants (e.g. spinal cord stimulators or pumps);
- All exclusion criteria for MR safety: any metallic implants, brain or skull abnormalities, tattoos on large body parts, and claustrophobia;
- Pregnancy, or inability to use an effective form of contraception in women of child-bearing age;
- Diabetes (type 1 or type 2);
- Lactose intolerance;
- Allergic reaction to naproxen or any NSAID;
- Any untoward reaction to l-dopa or carbidopa.
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
Cohorts and Interventions
Group / Cohort |
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CBP+mOUD
Chronic Back pain participants taking opioids and classified in the opioid misuse disorder group
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CBP+O
Chronic Back pain participants taking opioids and without opioid misuse disorder group
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CBP-O
Chronic Back pain participants not taking opioids
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Healthy Controls
Healthy control without pain or taking opioids.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To determine effects of opioid exposure on human brain anatomy and function in CBP using resting-state functional magnetic resonance (fMRI).
Time Frame: 1-2 years
|
We will test the impact of opioid use on brain anatomy and function.
For this, all participants will undergo a resting-state functional magnetic resonance (fMRI) exam.
Measures of brain anatomy and brain connectivity will be acquired and compared between the observational groups (CBP+O and CBP+mOUD, relative to CBP-O and healthy control).
We seek to establish risk factors and brain biomarkers for OUD and relate brain adaptations to exposure to both opioids and chronic pain.
|
1-2 years
|
To determine cognition, emotion, and motor abilities with opioid exposure in CBP, and to identify associated human brain maladptions.
Time Frame: 1-2 years
|
We will test the impact of opioid use on abilities in CBP+O and CBP+mOUD, relative to CBP-O and healthy controls.
For this participants will respond to questionnaires related to their thoughts and feelings.
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1-2 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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 31, 2018
Primary Completion (Actual)
February 23, 2023
Study Completion (Estimated)
June 30, 2024
Study Registration Dates
First Submitted
November 16, 2021
First Submitted That Met QC Criteria
January 10, 2022
First Posted (Actual)
January 24, 2022
Study Record Updates
Last Update Posted (Actual)
March 19, 2024
Last Update Submitted That Met QC Criteria
March 15, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- STU00207384
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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