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Peripheral Electrical Stimulation for Migraine Prevention

26. januar 2021 opdateret af: Taipei Veterans General Hospital, Taiwan

To Investigate the Effects of Peripheral Electrical Stimulation on Cortical Imagining, Electrophysiology and Clinical Profile in Patients With Migraine

Migraine is a common and disabling disease that affects more than 10% of the population worldwide. The prevalence of migraine in Taiwan is around 9.1%. The migraineurs missed 2 workdays due to migraine per year, that is 3.7 million estimated missed workdays in total and an estimated cost of 4.6 billion New Taiwan dollars. In addition, some migraineurs have poor response to the medications or suffer from adverse effects, and may further develop medication-overuse headache. Therefore, in recent years, efforts have been made to develop non-medication treatments, and the number of studies using neuromodulation as an intervention has increased dramatically. Among them, peripheral electrical stimulation has long been a routine treatment for pain in the clinic, and research has also shown its good evidence. In addition, recent studies have shown that peripheral electrical stimulation can also alter the cortical activities. Compared with the proximal brain stimulation, the remote electrical stimulation is safer, more convenient, less expensive and suitable for home use. To date, only one research had focused on the immediate anesthetic effect of remote electrical stimulation whereas the research for migraine prevention is still absent. Therefore, we expect to utilize a more remote electrical stimulation than trigeminal nerve electrical stimulation, which is the commonly used research method nowadays, as an interventional model. In three years, we will recruit 80 migraineurs along with 40 healthy controls and investigate the effects of 8-week home-based remote electrical stimulation on the prevention of migraine and the mechanisms using brain imaging, electrophysiological and biochemical examinations. We also aim to identify the predictors of the responders to remote electrical stimulation. If the effects of remote electrical stimulation are confirmed, as a non-drug neuromodulation management with features of non-invasive, low adverse effects and high accessibility, it will greatly lower the cost of social health care and better improve the quality of life and clinical status of the migraineurs.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

120

Fase

  • Ikke anvendelig

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

20 år til 65 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Migraine:

    1. Diagnosed as migraine by International Classification of Headache Disorder (ICHD-III) criteria
    2. onset before 50 years old
    3. 20-65 yrs.
    4. 4 or more migraine days per month in average

  • Healthy control:

    1. devoid of any systemic or neurological diseases

Exclusion Criteria:

  1. history of major systemic illness, including uncontrolled hypertension, diabetes, chronic renal insufficiency, autoimmune diseases or malignancies
  2. history of neurological disorders which might affect sensation such as previous stroke or peripheral neuropathy
  3. pregnancy or lactation
  4. epilepsy
  5. moderate depressed (BDI>20)
  6. using prophylactics for migraine
  7. other remote electrical stimulation contraindications, such as open wound, sensory impairment, metal implant
  8. other transcranial magnetic stimulation contraindications, such as, high intracranial pressure, cochlear implant, cranial metal implant
  9. other magnetic resonance imaging contraindications, such as, pacemaker, stent, metal implant, claustrophobia

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Sham-komparator: Sham stimulering
Enhed: peripheral electrical stimulation
The subjects will undergo 8-week home-based peripheral electrical simulation on the median nerve. The peripheral electrical simulation will be performed once a day for 30 minutes. The stimulation will be active or sham depend on the group assignment.
Eksperimentel: Aktiv stimulering
Enhed: peripheral electrical stimulation
The subjects will undergo 8-week home-based peripheral electrical simulation on the median nerve. The peripheral electrical simulation will be performed once a day for 30 minutes. The stimulation will be active or sham depend on the group assignment.
Ingen indgriben: sund kontrol

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
change in migraine or headache days of a month in average
Tidsramme: 2 months
change in migraine or headache days of a month in average
2 months
responder rate
Tidsramme: 2 months
responder rate (50% pain reduction from baseline)
2 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
change in moderate to severe headache days of a month in average
Tidsramme: 2 months
2 months
acute headache medication use
Tidsramme: 2 months
2 months
Beck Depression Inventory
Tidsramme: 2 months
2 months
modified Migraine Disability Scale
Tidsramme: 2 months
This modified Migraine Disability Scale assesses the migraine related disability in the past 1 month. The total score will be compared and the lower score stands for better outcome.
2 months
Patient/Clinical Global Impression of Change
Tidsramme: 2 months
Patient/Clinical Global Impression of Change (PGIC/CGIC) are 7-point scales to assess the improvement by patients themselves and by their clinicians.
2 months
Sensory threshold change after treatment
Tidsramme: 2 months
Using quantitative sensory testing (QST) to evaluate the sensory threshold before and after treatment
2 months
EEG change after treatment (1) Linear analysis of EEG before and after treatment
Tidsramme: 2 months
power spectal density change of EEG before and after treatment
2 months
EEG change after treatment (2) Nonlinear analysis of EEG before and after treatment
Tidsramme: 2 months
functional connectivity change of EEG before and after treatment
2 months
fMRI change after treatment
Tidsramme: 2 months
functional connectivity change of fMRI before and after treatment
2 months
MRI change after treatment
Tidsramme: 2 months
VBM changes of MRI before and after treatment
2 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Taipei Veterans General Hospital, Taiwan

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Forventet)

1. februar 2021

Primær færdiggørelse (Forventet)

30. juni 2022

Studieafslutning (Forventet)

31. december 2022

Datoer for studieregistrering

Først indsendt

2. april 2019

Først indsendt, der opfyldte QC-kriterier

2. april 2019

Først opslået (Faktiske)

3. april 2019

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. januar 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

26. januar 2021

Sidst verificeret

1. januar 2021

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2019-01-001C

Plan for individuelle deltagerdata (IPD)

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