Neurofeedback til behandling af neuropatisk smerte hos personer med diabetes
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Francois Pouwer, Professor
- Telefonnummer: +45 65 50 48 92
- E-mail: fpouwer@health.sdu.dk
Undersøgelse Kontakt Backup
- Navn: Johanne Axelsen, PhD-student
- E-mail: jlaxelsen@health.sdu.dk
Studiesteder
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Odense, Danmark, 5230
- Rekruttering
- University of Southern Denmark
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Kontakt:
- Johanne Axelsen, PhD-student
- Telefonnummer: +45 65 50 48 94
- E-mail: jlaxelsen@health.sdu.dk
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Ledende efterforsker:
- Francois Pouwer, Professor
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
Alder ≥18 og ≤82 år
- Diagnosticeret med 1) type 1-diabetes (i mindst 5 år) eller 2) type 2-diabetes
- Toronto-konsensuskriterierne vil blive brugt til en case-definition af DPN, hvor patienter skal have mindst sandsynlig DPN (31). Diagnose af DPN bekræftes med unormal DPN Check. Smertefuld DPN vil blive defineret ved hjælp af graderingssystemet for neuropatisk smerte (50) og vil være i overensstemmelse med IASP's definition af neuropatisk smerte, dvs. "smerte forårsaget af en læsion eller sygdom i det somatosensoriske system" (The Toronto consensus criteria).
- TCNS-score > 5
- Berettigede patienter med smertefuldt DPN skal have en smerteintensitet på mindst 4 på en 11-punkts numerisk vurderingsskala (NRS, 0-10) i mindst 3 måneder på mindst semi-daglig basis og ingen stærke smerter udover smerter pga. neuropati (smerteintensiteten vil være baseret på den smerte, som patienterne oplever under den aktuelle smertebehandling, hvis nogen).
- Stabil smertestillende medicin i > 1 måned før inklusion. Eksklusionskriterier
Ekskluderingskriterier:
- Samtidig neurologisk (neurodegenerative lidelser, migræne, epilepsi, slagtilfælde, tumor) eller klinisk signifikant psykiatrisk sygdom
- Neuropati eller neuropatisk smerte på grund af andre årsager end diabetes (vitamin B12-mangel, forudgående behandling med neurotoksisk kemoterapi, kronisk alkoholmisbrug, spinal stenose osv.)
- Ændring i nuværende smertebehandling under behandlingen (paracetamol er tilladt som redningsmedicin)
- Tidligere eller nuværende overdreven alkoholbrug (>14 eller >21 enheder/uge for henholdsvis kvinder og mænd) eller ulovligt stofmisbrug
- Positivt urin hCG-testresultat, der indikerer graviditet
- Morfinforbrug >20mg/dag
- Blindhed eller alvorligt nedsat syn
- Investigatoren finder patienten uegnet til undersøgelsen (f. på grund af brug af alkohol eller stoffer, mental invaliditet, uvilje eller sprogbarriere, der udelukker tilstrækkelig forståelse eller samarbejde eller tilstedeværelse af enhver tilstand, som efter efterforskernes mening kan føre til dårlig overholdelse af studieprotokollen).
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: Ægte EEG-neurofeedback
NF-interventionsgruppen vil modtage feedback baseret på den ægte EEG-aktivitet i realtid
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Traditional neurofeedback uses one or two electrodes to modulate activity within a specific frequency band.
Standardized Weighted Low Resolution Electromagnetic Tomography (swLORETA) analyzes the 3D distribution of intracortical brain electrical activity based on surface EEG recordings, enabling real-time brainwave imaging with a spatial resolution under one cubic centimeter.
This divides the brain into over 12,000 voxels, offering localization similar to fMRI while maintaining EEG's faster temporal resolution.
Source-localized NF can target specific, deeper brain regions, multiple Brodmann areas simultaneously, and provide feedback on connectivity between neural sources, enabling the training of specific neural networks.
swLORETA metrics are compared to a normative database of neurotypical brains to produce z-scores for each area and metric.
NeuroGuide is used within the FDA 510(k)-cleared NeuroGuide Analysis System (K041263); clearance does not imply treatment validation.
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Sham-komparator: Sham EEG-neurofeedback
Sham-gruppen vil modtage en anden deltagers EEG-træningsprotokol som et forudindspillet signal.
Feedbacksignalet vil bestå af 15-25 belønninger i minuttet.
I mellemtiden forbliver tærsklen for den falske gruppe fast, hvilket sikrer en konsekvent 70 % positiv feedbackrate.
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Traditional neurofeedback uses one or two electrodes to modulate activity within a specific frequency band.
Standardized Weighted Low Resolution Electromagnetic Tomography (swLORETA) analyzes the 3D distribution of intracortical brain electrical activity based on surface EEG recordings, enabling real-time brainwave imaging with a spatial resolution under one cubic centimeter.
This divides the brain into over 12,000 voxels, offering localization similar to fMRI while maintaining EEG's faster temporal resolution.
Source-localized NF can target specific, deeper brain regions, multiple Brodmann areas simultaneously, and provide feedback on connectivity between neural sources, enabling the training of specific neural networks.
swLORETA metrics are compared to a normative database of neurotypical brains to produce z-scores for each area and metric.
NeuroGuide is used within the FDA 510(k)-cleared NeuroGuide Analysis System (K041263); clearance does not imply treatment validation.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Pain intensity
Tidsramme: Seven consecutive days before baseline EEG assessment (T0; days -7 to -1) and seven consecutive days following the 10th and final neurofeedback session (T1; days +1 to +7).
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The primary aim is to evaluate whether real EEG-NF compared with sham EEG-NF, leads to a greater reduction in self-reported pain intensity (NRS from 0-10) from T0 (baseline) to T1 (after 10th and final session), assessed using mean 7-day pain intensity derived from an electronic pain diary.
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Seven consecutive days before baseline EEG assessment (T0; days -7 to -1) and seven consecutive days following the 10th and final neurofeedback session (T1; days +1 to +7).
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Neuropathic pain symptoms
Tidsramme: Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Differences in neuropathic pain symptoms will be assessed using the Neuropathic pain scale (NPS).
Changes from baseline will be evaluated following the intervention and at 4-month follow-up, and differences between the real EEG-NF and sham EEG-NF groups will be examined.
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Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Pain interference
Tidsramme: Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Pain interference will be assessed using the Brief Pain Inventory (BPI) interference scale.
Changes from baseline will be evaluated following the intervention and at 4-month follow-up, and differences between the real EEG-NF and sham EEG-NF groups will be examined.
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Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Sleep
Tidsramme: Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Sleep disturbance will be assessed using the PROMIS sleep measure.
Changes over time and between-group differences will be examined.
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Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Pain network abnormality burden
Tidsramme: Baseline EEG assessment and post-treatment EEG assessment after completion of the 10th and final neurofeedback session.
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Neurophysiological outcomes will be assessed using normative z-scores within the predefined pain-related network.
A composite pain-network abnormality burden will be derived across EEG features, with domain-specific measures for current source density (CSD), instantaneous coherence, and lagged coherence also examined.
Changes from pre- to post-intervention will be compared between the real EEG-NF and sham EEG-NF groups.
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Baseline EEG assessment and post-treatment EEG assessment after completion of the 10th and final neurofeedback session.
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Global impression of change
Tidsramme: After completion of the 10th and final neurofeedback session (T1) and at 4-month follow-up (T2).
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Participants' overall perceived change in their condition will be assessed using the Patient Global Impression of Change (PGIC).
Ratings following treatment and at follow-up will be summarized and compared between the real EEG-NF and sham EEG-NF groups as a supportive secondary outcome.
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After completion of the 10th and final neurofeedback session (T1) and at 4-month follow-up (T2).
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Pain catastrophizing
Tidsramme: Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Pain catastrophizing and coping will be assessed using the Pain Catastrophizing Scale (PCS).
Changes from baseline will be evaluated following the intervention and at 4-month follow-up, and differences between the real EEG-NF and sham EEG-NF groups will be examined.
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Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Quality of Life
Tidsramme: Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Quality of life will be assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF).
Changes from baseline will be evaluated following the intervention and at 4-month follow-up, and differences between the real EEG-NF and sham EEG-NF groups will be examined.
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Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Daily sleep interference
Tidsramme: Seven consecutive days before baseline (T0; days -7 to -1) and seven consecutive days following the 10th and final neurofeedback session (T1; days +1 to +7).
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Sleep interference will be assessed using daily self-reported ratings collected as part of the electronic diary.
Mean ratings will be derived for the predefined baseline and post-intervention assessment periods.
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Seven consecutive days before baseline (T0; days -7 to -1) and seven consecutive days following the 10th and final neurofeedback session (T1; days +1 to +7).
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Brief Pain Inventory (BPI) pain severity score
Tidsramme: Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Pain severity will be assessed using the pain severity items of the Brief Pain Inventory (BPI).
Changes over time and differences between the real EEG-NF and sham EEG-NF groups will be examined, with the 4-month follow-up used to assess durability of treatment effects.
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Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Mood
Tidsramme: Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Mood will be assessed using the PROMIS mood measure.
Changes over time and between-group differences will be examined.
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Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Fatigue
Tidsramme: Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Fatigue will be assessed using the PROMIS fatigue measure.
Changes over time and between-group differences will be examined.
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Inclusion visit (pre-intervention), post-treatment assessment (after the 10th and final neurofeedback session), and 4 months after completion of the intervention.
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 11.719
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