Efficacy of Transcranial Direct-Current Stimulation (tDCS) for Provoked Vestibulodynia : a Triple Blind Randomized Controlled Trial (PVD/tDCS)
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Typ studie
Typ studie
Zápis (Aktuální)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
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Quebec
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Sherbrooke, Quebec, Kanada, J1H 5N4
- Centre Hospitalier Universitaire de Sherbrooke
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Sherbrooke, Quebec, Kanada, J1H 5N4
- Centre hospitalier Universitaire de Sherbroke
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- Experience moderate to severe pain in at least 90% of attempted sexual intercourse;
- Experience moderate to severe pain during cotton swab test, in one or more regions of the vestibule (minimum of 5/10 on a subjective numeric scale of pain intensity);
- Pain limited to the vestibule during vaginal intercourse and during activities exerting pressure on the vestibule (tampon insertion, tight jeans or pants, cycling, horseback riding);
- Presence of PVD for at least 6 months and diagnosed according to the standardized gynecological examination protocol by one of our staff gynecologists;
- Have a stable sexual partner with regular sexual activity including penetration.
Exclusion Criteria:
- Other pelvic pathology associated with pelvic pain (e.g., deep dyspareunia);
- Chronic pain conditions (e.g. fibromyalgia, low back pain, chronic migraines);
- Use of medication that can influence the perception of pain (eg analgesic, opioids, antiepileptic, muscle relaxant);
- Pregnancy for less than one year and breastfeeding;
- Anterior vulvar or vaginal surgery;
- Refusal to refrain from other treatments one month prior to first treatment study until the last 3-month follow-up assessment;
- Important urogynecologic symptoms (urinary or anal incontinence, urinary urgency, pelvic organ prolapse, active urinary tract or vaginal infection or earlier in the last 3 months, etc.);
- Contraindications to tDCS (e.g. metallic implant in or near the skull, history of epilepsy, pacemaker);
- Previously received tDCS treatment.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Čtyřnásobek
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
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Experimentální: Intervention
Participants will receive active transcranial direct-current stimulation (tDCS) for ten 20 minute sessions of 2 mA stimulation over a 2-week period.
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tDCS is a painless technique which consists in applying low direct-current through electrodes (one electrode serving as an anode, the other as a cathode) placed on the scalp to target the cerebral cortex.
In patients with chronic pain, the anode is commonly placed over the motor cortex (M1) (Valeriani et al., 1999).
Ostatní jména:
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Falešný srovnávač: Placebo
Participants will receive sham transcranial direct-current stimulation (tDCS) for ten 20 minute sessions of 2 mA stimulation over a 2-week period.
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tDCS is a painless technique which consists in applying low direct-current through electrodes (one electrode serving as an anode, the other as a cathode) placed on the scalp to target the cerebral cortex.
In patients with chronic pain, the anode is commonly placed over the motor cortex (M1) (Valeriani et al., 1999).
Ostatní jména:
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Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
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Pain during intercourse (Numeric rating scale)
Časové okno: Change in the NRS scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Pain during intercourse will be assessed using a numeric rating scale (NRS) ranging from 0 to 10, where 0 is no pain at all, and 10 is the worst pain ever.
This method for measuring pain has been shown to detect significant treatment effects in women with PVD and demonstrates a significant positive correlation with other pain intensity measures.
Pain during intercourse is the main symptom of PVD and the one that most interferes with quality of life, hence the most relevant measure of functional outcome (Bergeron et al., 2008; Bergeron et al., 2001; Morin et al., 2010; Morin et al., 2011).
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Change in the NRS scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Pain (McGill-Melzack questionnaire)
Časové okno: Change in the McGill-Melzack scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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The McGill-Melzack questionnaire allows the assessment of sensory, affective and evaluative components of pain.
This world-renowned questionnaire, studied for its validity, reliability and responsiveness to change, is commonly used in RCTs (Bergeron et al., 2001; Melzack, 1975; Davidoff et al., 1987; Hays et al., 1994; Bansal et al., 2009; Moy et al., 2011; Foster et al., 2010).
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Change in the McGill-Melzack scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Vestibular sensitivity (algometer)
Časové okno: Change in the pain threshold and pain tolerance scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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A gradual pressure (1 to 1000 g) will be applied to three distinct points of the vestibule at the 3, 6 and 9 o'clock positions (Cyr et al., 2014).
Each of these pressure points will be applied randomly (e.g.
3,6,9 or 3,9,6 or 6,9,3.).
During this procedure, each participant will be asked to indicate when they start to feel pain (pain threshold) and subsequently the maximal pressure that can be tolerated (pain tolerance).
Pain intensity is assessed throughout the test using a Computerized Visual analog scale (CoVas).
This assessment has shown good reliability and validity (Cyr et al., 2014).
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Change in the pain threshold and pain tolerance scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Female Sexual Function Index (FSFI)
Časové okno: Change in the FSFI scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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The Female Sexual Function Index (FSFI) is a multidimensional measure of sexual function evaluating desire, arousal, lubrication, orgasm, satisfaction and pain.
In addition to good psychometric properties (reliability, internal consistency and responsiveness to change (Rosen et al., 2000; Goldfinger et al, 2009), normative data are available for this questionnaire suggesting clinical level of dysfunctions (Wiegel et al., 2005).
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Change in the FSFI scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Pain Catastrophizing Scale (PCS)
Časové okno: Change in the PCS scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Pain catastrophizing will be assessed using the Pain Catastrophizing Scale (Sullivan, Bishop, & Pivik, 1995), which consists of 13 items measuring exaggerated negative thoughts and feelings about the meaning of pain.
Items are scored on a 5-point scale with the end points (0) not at all and (4) all the time.
The PCS is a reliable and valid measure that has demonstrated a stable factorial structure across clinical and general populations, including a French population (French et al., 2005; Osman et al., 2000; Sullivan, et al., 1995).
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Change in the PCS scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Spielberg State-Trait Anxiety Inventory (IASTA)
Časové okno: Change in the IASTA state and IASTA trait scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Anxiety will be assessed using the Spielberger State-Trait Anxiety Inventory (STAI - (Spielberger, Gorsuch, & Lushene, 1970); ASTA - (Gauthier & Bouchard, 1993)).
The STAI is a 40-item, well-known and widely used measure of state and trait anxiety that has demonstrated very good psychometric properties (Cronbach's alpha State = .93,
Trait = .97)
in various clinical and non-clinical samples including pain populations (Gauthier & Bouchard, 1993; Greenberg & Burns, 2003; Rule & Traver, 1983; Tanaka-Masumi & Kameoka, 1986).
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Change in the IASTA state and IASTA trait scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Beck Depression Inventory questionnaire (BDI-II)
Časové okno: Change in the BDI scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Depression or depression symptoms will be measured with the Beck Depression Inventory-II (BDI-II).
The BDI-II is comprised of 21 items, with scores for most items ranging from 0 (low intensity) to 3 (high intensity) (Beck, Steer & Brown, 1996; Beck, Steer & Garvin, 1988).
This measure of depression has been validated for use in chronic pain populations (Turner & Romano, 1984).
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Change in the BDI scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Pain Anxiety Symptoms Scale (PASS-20)
Časové okno: Change in the PASS-20 scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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The Pain Anxiety Symptoms Scale (PASS-20), evaluating fear of pain, also shows good psychometric properties (Coons, Hadjistavropoulos & Asmundson, 2004; McCracken & Dhingra, 2002).
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Change in the PASS-20 scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Patient's global impression of change (PGIC)
Časové okno: Change in the PGIC scores from 2-week post-treatment to 3-month post-treatment
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Patient self-reported improvement [scale of 0 (completely dissatisfied) to 10 (completely satisfied)] and treatment satisfaction [scale of 0 (worse) to 10 (complete cure)] will be measured at the 2-week post-treatment and 3-month post-treatment structured interview in order to assess the clinical significance of results.
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Change in the PGIC scores from 2-week post-treatment to 3-month post-treatment
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Global Measure of Sexual Satisfaction scale (GMSS)
Časové okno: Change in the GMSS scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Sexual satisfaction will be assessed using the Global Measure of Sexual Satisfaction scale, which consists of 5 items assessing global sexual satisfaction.
Internal consistency of this scale is high (alpha = 0.90), as is test-retest reliability (r = 0.84) (Lawrance & Byers, 1998).
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Change in the GMSS scores from pre- to 2-week post-treatment, and from pre-treatment to 3-month post-treatment
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Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Publikace a užitečné odkazy
Užitečné odkazy
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Začátek studia
Primární dokončení (Aktuální)
Primární dokončení
Dokončení studie (Aktuální)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
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Aktualizace studijních záznamů
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Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
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Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
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Další identifikační čísla studie
- 14-169
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