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TENS of Auricular Vagal Nerve for Radiation Necrosis

25. juni 2026 opdateret af: Virginia Commonwealth University

Transcutaneous Auricular Vagal Nerve Stimulation for Treatment of Radiation Necrosis

This is a multi-center, randomized, blinded trial evaluating the effect of transcutaneous auricular vagal nerve stimulator (taVNS) on radiation necrosis-related cerebral edema. In this study, consenting and eligible patients will be assigned to one of two arms: treatment (Arm 1) or sham (Arm 2). Patients in both arms will have imaging performed and tissue and blood collected for assessment of changes in area of contrast enhancement and cerebral edema, inflammatory markers, and markers of blood-brain barrier permeability.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

40

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Forenede Stater
    • Virginia
      • Richmond, Virginia, Forenede Stater, 23298
        • Virginia Commonwealth University
        • Kontakt:
        • Ledende efterforsker:
          • Ryan Cleary, MD

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • History of glioma or metastatic brain lesion previously treated with whole brain radiation, stereotactic radiation surgery, or fractionated radiation therapy
  • Magnetic resonance imaging (MRI) findings consistent with possible radiation necrosis within 6 weeks prior to enrollment.
  • Candidate for tissue biopsy and Laser Interstitial Thermal Therapy (LITT) ablation of the lesion
  • At least 18 years of age
  • If on corticosteroids, able to discontinue at least 5 days prior to start of transcutaneous auricular vagus nerve stimulation (taVNS) (Arm 1) or sham treatment (Arm 2). A stable physiologic dose of corticosteroids, if used as hormone replacement therapy, may be allowed upon discussion with the investigator. 6. Ability to understand and willingness to sign an institutional review board (IRB) approved written informed consent document. Legally authorized representatives may sign and give informed consent on behalf of study participants.

Exclusion Criteria:

  • New onset neurologic deficits secondary to radiation necrosis requiring initiation of dexamethasone therapy or other intervention prior to enrollment
  • Currently receiving bevacizumab for treatment of radiation necrosis or has received bevacizumab < 6 weeks prior to study enrollment.
  • Currently receiving any investigational agents for treatment of radiation necrosis or has participated in a study of an investigational agent for radiation necrosis within 3 weeks prior to study enrollment.
  • History of cardiac conduction disorders or presence of implanted electronic devices
  • Active Crohn's disease or other inflammatory bowel disease.
  • Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 14 days of study entry.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Støttende pleje
  • Tildeling: Randomiseret
  • Interventionel model: Crossover opgave
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Sham-komparator: Falsk
Enhed: Sham
TENS (transcutaneous electrical nerve stimulation) unit connected to an earpiece that fits into the concha of the ear, with no stimulation twice daily for 12 to 14 days prior to planned LITT ablation.
Eksperimentel: Transkutan Auricular Vagal Nerve Stimulation (taVNS)
Enhed: Transcutaneous auricular vagal nerve stimulation (taVNS)
Transcutaneous auricular vagal nerve stimulation (taVNS) stimulation twice daily for 12 to 14 days prior to planned LITT ablation via TENS (transcutaneous electrical nerve stimulation) unit connected to an earpiece that fits into the concha of the ear.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Assess changes in the serum inflammatory marker Tumor Necrosis Factor (TNF)-alpha
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory marker TNF-alpha utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Assess changes in serum inflammatory marker Interleukin 12 (IL-12)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in (IL-12) serum inflammatory marker utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker granulocyte-macrophage colony-stimulating factor (GMCSF)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory marker GMCSF utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker Interferon gamma (IFN gamma)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory marker IFN gamma utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker interleukin 1 beta (IL-1b)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory marker IL-1b utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker interleukin-10 (IL-10)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory marker IL-10 utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker interleukin 13 (IL-13)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory marker IL-13 utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker interleukin (IL-2)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory marker IL-2 utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory markers interleukin 17 (IL-17A)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory markers IL-17A utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker interleukin 4 (IL-4)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory marker IL-4 utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker interleukin 5 (IL-5)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory markers IL-5 utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker interleukin 6 (IL-6)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory markers IL-6 utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in serum inflammatory marker interleukin 8 (IL-8)
Tidsramme: Baseline, 1 week, and 2 weeks following intervention
Percent change in serum inflammatory markers IL-8 utilizing serum inflammatory marker analysis from collected blood samples
Baseline, 1 week, and 2 weeks following intervention
Assess changes in biomarker Neurofilament light chain (NFL) of central nervous system (CNS) injury following treatment
Tidsramme: Baseline, and 2 weeks following intervention
Percent change of NFL marker of CNS inflammation utilizing serum inflammatory marker analysis from collected blood samples
Baseline, and 2 weeks following intervention
Assess changes in biomarker platelet-derived growth factor receptor-beta (PDGFR-beta) of central nervous system (CNS) injury following treatment
Tidsramme: Baseline, and 2 weeks following intervention
Percent change of marker PDGFR-beta of CNS inflammation utilizing serum inflammatory marker analysis from collected blood samples
Baseline, and 2 weeks following intervention
Assess changes in biomarker vascular endothelial growth factor (VEGF) of central nervous system (CNS) injury following treatment
Tidsramme: Baseline, and 2 weeks following intervention
Percent change of marker VEGF of CNS inflammation utilizing serum inflammatory marker analysis from collected blood samples
Baseline, and 2 weeks following intervention
Assess changes in biomarkers of blood-brain barrier (BBB) permeability following treatment
Tidsramme: Baseline, and 2 weeks following intervention
Percent change of BBB permeability
Baseline, and 2 weeks following intervention
Assess interval changes in radiation necrosis on MRI after treatment w taVNS
Tidsramme: Baseline, and 2 weeks following intervention
Percent changes in areas of contrast enhancement and perilesional T2-weighted fluid-attenuated inversion recovery (T2/FLAIR) Hypersensitivity on magnetic resonance imaging (MRI). On these images, areas with higher water content suck as edema, inflammation, or demyelination, appear brighter compared to surrounding tissue.
Baseline, and 2 weeks following intervention
Assess interval changes in cerebral edema on MRI after treatment
Tidsramme: Baseline, and 2 weeks following intervention
Percent changes in areas of contrast enhancement and perilesional T2/FLAIR Hypersensitivity on MRI
Baseline, and 2 weeks following intervention

Samarbejdspartnere og efterforskere

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

Sponsor

Virginia Commonwealth University

Efterforskere

  • Ledende efterforsker: Ryan Cleary, MD, Virginia Commonwealth University

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 (Anslået)

31. juli 2026

Primær færdiggørelse (Anslået)

31. august 2029

Studieafslutning (Anslået)

31. august 2029

Datoer for studieregistrering

Først indsendt

25. juni 2026

Først indsendt, der opfyldte QC-kriterier

25. juni 2026

Først opslået (Faktiske)

2. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • MCC-25-22821

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ja

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