- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05487664
RM1 Project 2 - tAN fMRI
Determining the Independent and Synergistic Effects of Transcutaneous Auricular Neurostimulation (tAN) on Direct Brain Activation in Healthy Individuals
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The demand for chronic pain treatment has demonstrated an unprecedented increase over the last several decades, in part contributing to an unsustainable surge in opioid prescriptions. Countless patients were escalated to prolonged, high-dose opioid regimens over years of treatment. By 2014, 5.4% of US adults were estimated to use prescription opioids on a long-term basis. As the harms of opioid proliferation became increasingly clear, a dramatic paradigm shift occurred in which these drugs came to be seen as often more dangerous than beneficial for chronic pain. New clinical guidelines highlighted the risks of high-dose regimens as well as limited benefits, particularly insufficient analgesia, associated with long-term use. According to this new perspective, the preferred therapeutic modality for many patients is to significantly reduce, or even completely stop, using opioids.
Stimulation of the ABVN has demonstrated additional benefits for reducing the need for opioids for pain as well as lessening opioid withdrawal symptoms. Clinical trials of ABVN stimulation as an adjunctive treatment for pain have noted decreased intake of tramadol , remifentanil, morphine, as well as naproxen plus tramadol. A pioneering study of electrical stimulation at the cymba conchae in eight persons with opioid use disorder found significantly reduced withdrawal symptoms: first, decreases in anxiety, craving for opioids, chills, nausea; second, reduced bone and joint pain. Results in follow-up clinical trials bolstered the efficacy of ABVN stimulation for opioid withdrawal . More recently, an open-label trial of simultaneous ABVN and trigeminal stimulation found reduced withdrawal symptoms and decreased need for morphine maintenance in newborns with neonatal opioid withdrawal syndrome . This method of simultaneous vagal and trigeminal stimulation via the external ear is known as transcutaneous auricular neurostimulation (tAN), as the targets of electrical stimulation include the ABVN and auriculotemporal nerve (ATN), which is a branch of the mandibular division of the trigeminal nerve. Electrodes applied to select dermatome regions can target ear neural structures and deliver non-invasive vagus nerve stimulation (VNS) and trigeminal nerve stimulation (TNS). See Figure 1.
Use of tAN devices for pain relief is an attractive alternative to pharmacologic and opioid-based approaches because it is safe and effective and presents no addiction liability. In order to increase clinical adoption and optimize efficacy of these devices, the mechanism of action must be fully characterized.
This study is investigating the mechanism behind tAN in a healthy cohort. Using tAN combined with advanced neuroimaging, we hope to begin to understand what parts of the brain are activated during tAN, compared to sham.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Bashar Badran, PhD
- Phone Number: 843-792-6076
- Email: badran@musc.edu
Study Locations
-
-
South Carolina
-
Charleston, South Carolina, United States, 29425
- Recruiting
- Medical University of South Carolina Institute of Psychiatry
-
Contact:
- Bashar W Badran, PhD
- Phone Number: 843-792-6076
- Email: badran@musc.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18-65
- Have the capacity and ability to provide one's own consent and sign the informed consent document
Exclusion Criteria:
- Contraindicated for MRI.
- Any current or recent untreated medical, neurological, or psychiatric conditions
- Metal implant devices in the head, heart or neck.
- History of brain surgery.
- History of myocardial infarction or arrhythmia, bradycardia.
- Personal or family history of seizure or epilepsy or personal use of medications that substantially reduce seizure threshold (e.g., olanzapine, chlorpromazine, lithium).
- Personal history of head injury, concussion, or self-report of moderate to severe traumatic brain injury.
- Individuals suffering from frequent/severe headaches.
- Individuals with a reported history of psychosis or mania, or individuals who are actively manic or psychotic.
- Moderate to severe alcohol or substance use disorder.
- Pregnancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Auricular Neurostimulation (Active 1)
•Within the MRI scanner, each participant will be connected to a series of tAN electrodes that stimulate the following ear target -ABVN Only stimulation (15Hz stimulation of cymba conchae) |
The intervention we are studying is called transcutaneous auricular neurostimulation (tAN).
tAN is simply electrical nerve stimulation administered at the ear which targets both the auricular branch of the vagus nerve (ABVN) and the auriculotemporal nerve (ATN, a branch of the trigeminal nerve).
|
Active Comparator: Auricular Neurostimulation (Active 2)
•Within the MRI scanner, each participant will be connected to a series of tAN electrodes that stimulate the following ear target -ATNS Only stimulation (100Hz stimulation of the tragus) |
The intervention we are studying is called transcutaneous auricular neurostimulation (tAN).
tAN is simply electrical nerve stimulation administered at the ear which targets both the auricular branch of the vagus nerve (ABVN) and the auriculotemporal nerve (ATN, a branch of the trigeminal nerve).
|
Active Comparator: Auricular Neurostimulation (Active 3)
•Within the MRI scanner, each participant will be connected to a series of tAN electrodes that stimulate the following ear target -Combo stimulation (stimulation of both the 15Hz cymba conchae and 100HZ tragus) |
The intervention we are studying is called transcutaneous auricular neurostimulation (tAN).
tAN is simply electrical nerve stimulation administered at the ear which targets both the auricular branch of the vagus nerve (ABVN) and the auriculotemporal nerve (ATN, a branch of the trigeminal nerve).
|
Sham Comparator: Auricular Neurostimulation (Sham 1)
•Within the MRI scanner, each participant will be connected to a series of tAN electrodes that stimulate the following ear target -Sham (15Hz stimulation of the earlobe) |
The intervention we are studying is called transcutaneous auricular neurostimulation (tAN).
tAN is simply electrical nerve stimulation administered at the ear which targets both the auricular branch of the vagus nerve (ABVN) and the auriculotemporal nerve (ATN, a branch of the trigeminal nerve).
|
Sham Comparator: Auricular Neurostimulation (Sham 2)
•Within the MRI scanner, each participant will be connected to a series of tAN electrodes that stimulate the following ear target -Sham (100Hz stimulation of the earlobe) |
The intervention we are studying is called transcutaneous auricular neurostimulation (tAN).
tAN is simply electrical nerve stimulation administered at the ear which targets both the auricular branch of the vagus nerve (ABVN) and the auriculotemporal nerve (ATN, a branch of the trigeminal nerve).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
BOLD signal changes during stimulation relative to no stimulation
Time Frame: During tAN
|
. tAN will will be administered to participants within the bore of the MRI scanner while we acquire high resolution functional neuroimaging.
Both a general linear model and SNM approach will be used to examine BOLD signal changes during stimulation relative to rest blocks, comparing each of the four stimulation targets within- and between subjects to determine whether stimulating two cranial nerves produces a more robust neurophysiological effect than either single nerve or sham stimulation alone.
|
During tAN
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- Pro00122682
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Auricular Stimulation
-
Xin Jiang, MDUnknownGreat Auricular NerveChina
-
Mohamed Mahmoud DohiemRecruiting
-
National Taipei University of Nursing and Health...Taipei City HospitalCompletedConditions:Effectiveness of Auricular Acupressure on the Methadone PatientTaiwan
-
National Taipei University of Nursing and Health...Taipei Veterans General Hospital, TaiwanCompletedAuricular Acupressure | Cervical Spine SurgeryTaiwan
-
Case Western Reserve UniversityCompletedSpinal Cord Stimulation | High-frequency Stimulation | High-density StimulationUnited States
-
Bryn LloydInstitute for Biomedical Engineering, Swiss Federal Institute of Technology...CompletedElectric Stimulation | Peripheral Nerve Stimulation in MRISwitzerland
-
University of ZurichUniversity Hospital Inselspital, BerneRecruitingTranscranial Magnetic Stimulation | Electric Stimulation TherapySwitzerland
-
Bar-Ilan University, IsraelRecruitingTranscranial Direct Current Stimulation | Transcranial Alternating Current StimulationIsrael
-
University Hospital, GrenobleUnknownHealthy | Transcranial Magnetic Stimulation | Transcranial Direct Current StimulationFrance
-
University of Castilla-La ManchaHospital Nacional de Parapléjicos de ToledoUnknownSpinal Cord Stimulation | Transcutaneous Electrical Nerve Stimulation | Dose-response RelationshipSpain
Clinical Trials on Transcutaneous Auricular Neruostimulation (tAN)
-
Spark Biomedical, Inc.CompletedOpioid-use Disorder | Opioid WithdrawalUnited States
-
Spark Biomedical, Inc.Medical University of South CarolinaCompleted
-
University of Texas Southwestern Medical CenterNot yet recruitingPain, Postoperative | Opioid Use | Lumbar Spine InjuryUnited States
-
The University of Texas Medical Branch, GalvestonNational Institute of Neurological Disorders and Stroke (NINDS)RecruitingUnderstanding the Effects of Transcutaneous Auricular Neurostimulation for Treatment of Chronic PainAnalgesia | Opioid WithdrawalUnited States
-
Jiani WuNot yet recruiting
-
Nanfang Hospital, Southern Medical UniversityBrainClos Co., LTD.; Zhuhai Fudan Innovation InstituteNot yet recruitingCluster Headache | Migraine in Children | Tension Headache | Migraine in Adolescence | Primary HeadacheChina
-
The First Affiliated Hospital with Nanjing Medical...Not yet recruitingParkinson DiseaseChina
-
Medical University of South CarolinaRecruitingHypermobile Ehlers-Danlos Syndrome | Ehlers-Danlos Syndrome | Hypermobile Spectrum DisorderUnited States
-
Medical University of South CarolinaRecruiting
-
University of MiamiRecruiting