Auricular Vagus Nerve Stimulation Mechanisms for HIV-Associated Peripheral Neuropathy
Mechanistic Modulation of HIV-Associated Peripheral Neuropathy in Older Adults Via Auricular Vagus Nerve Stimulation
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Marlon L Wong, PT, PhD
- Telefonnummer: 3052842670
- E-Mail: mwong2@miami.edu
Studieren Sie die Kontaktsicherung
- Name: Richard Martinez, MS
- Telefonnummer: 305-284-2359
- E-Mail: rxm1388@med.miami.edu
Studienorte
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Florida
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Miami, Florida, Vereinigte Staaten, 33136
- Christine E Lynn Rehabilitation Center
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Kontakt:
- Marlon L Wong, PT, PhD
- E-Mail: mwong2@miami.edu
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Hauptermittler:
- Marlon L. Wong, PT, PhD
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Kontakt:
- Richard A Martinez, MS
- Telefonnummer: 305-284-2359
- E-Mail: rxm1388@med.miami.edu
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Established HIV infection
- Glove/stocking dysesthesias lasting for ≥3 months
- HIV-associated peripheral neuropathy (HIV-PN) related symptoms ≥4 (on a scale of 0-10) within the last week
- Stable medical care (i.e., no changes in Antiretroviral Therapy or pain medication within 2 months of enrollment)
- Able to read the consent form, demonstrate understanding of study procedures and requirements, and independently provide written informed consent
Exclusion Criteria:
- Unstable cardiac disease
- Implanted electronic or magnetic devices (e.g., pacemaker, cochlear implants, medication pumps, and other implanted neurostimulation systems)
- Head or neck cancer or metastases
- Recent ear trauma or metal implants in the head
- History of epilepsy, unprovoked seizure, stroke, brain tumor, significant traumatic brain injury, prior intracranial surgery, or other neurological condition associated with increased seizure risk
- Active or uncontrolled comorbidities that independently cause neuropathy (e.g., recent chemotherapy, uncontrolled diabetes with documented neuropathic complications)
- Clinical evidence of non-HIV neuropathy (e.g., neuropathic symptoms predating HIV diagnosis, uncontrolled diabetes)
- Known allergy to tape/adhesive
- Ferromagnetic or non-MRI-compatible metal in the head, neck, eye, or cranial region, including aneurysm clips, retained metal fragments, bullets, shrapnel, or other metallic implants not demonstrated to be TMS-compatible.
- Pregnancy or actively breast feeding
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
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Experimental: Auricular Vagus Nerve (AVNS) Group
Participants in this group will receive 6 sessions of transcutaneous auricular vagus nerve stimulation (AVNS) over 2 weeks.
Each stimulation session will last approximately 90 minutes at monophasic pulses.
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Transcutaneous auricular vagus nerve stimulation (taVNS) will be administered at the cymba concha using hydrogel electrodes and a Digitimer DS8R biphasic constant-current stimulator.
Participants will receive 90-minute stimulation sessions consisting of monophasic pulses (pulse width: 500 microseconds; frequency: 25 Hz; duty cycle: 50%).
Stimulation intensity will be set at 200% of the participant's sensory perception threshold and may be adjusted up to 5 milliamperes (mA) while remaining below the pain threshold.
Andere Namen:
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Kein Eingriff: Waitlist Control
Participants in this group will not receive an intervention.
Participants will be placed on a waitlist to try the intervention and will be assessed pre and post the 2-week waiting period.
No stimulation device is provided, and no active treatment or experimental procedure is administered during the 14-day waitlist period.
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Change in Short Interval intraCortical Inhibition (SICI)
Zeitfenster: Baseline (Day 0), Post-trial (Day 14)
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Short-interval intracortical inhibition (SICI) will be assessed using paired-pulse transcranial magnetic stimulation (TMS) with a MagPro X100 stimulator.
Change in SICI will be calculated as the difference between post-intervention and pre-intervention measurements.
Negative values indicate increased intracortical inhibition.
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Baseline (Day 0), Post-trial (Day 14)
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Change in Root Mean Square of Successive Differences (RMSSD)
Zeitfenster: (Days 1-13), Post-trial (Day 14)
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The root mean square of successive differences (RMSSD), will be assessed using a three-lead electrocardiogram (ECG).
Change in RMSSD will be calculated as the difference between post-intervention and baseline measurements.
Higher RMSSD values indicate greater parasympathetic (vagal) activity and heart rate variability.
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(Days 1-13), Post-trial (Day 14)
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Change in Neuropathic Pain Symptom Severity (NPSI)
Zeitfenster: Baseline (Day 0), post-trial (Day 14)
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Neuropathic pain symptom severity will be assessed using the Neuropathic Pain Symptom Inventory (NPSI), a patient-reported questionnaire that evaluates 10 neuropathic pain symptoms on an 11-point numeric scale ranging from 0 (no symptom) to 10 (worst symptom severity imaginable).
The NPSI also includes 2 items assessing the duration of ongoing pain and the frequency of pain attacks.
Higher scores indicate greater neuropathic pain symptom severity.
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Baseline (Day 0), post-trial (Day 14)
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Change in Neuropathic Symptom Intensity (Numeric Rating Scale)
Zeitfenster: Baseline (Day 0), pre/post each treatment session (Days 1-13), post-trial (Day 14), and at follow up (Day 45)
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Neuropathic symptom intensity will be assessed using the 0-10 Numeric Rating Scale (NRS).
Participants will rate the average severity of HIV-associated peripheral neuropathy symptoms from 0 (not bothersome) to 10 (worst imaginable).
Higher scores indicate greater symptom intensity.
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Baseline (Day 0), pre/post each treatment session (Days 1-13), post-trial (Day 14), and at follow up (Day 45)
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Change in Serum Neurofilament Light Chain (NfL)
Zeitfenster: Baseline (Day 0), Post-trial (Day 14)
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Serum neurofilament light chain (NfL) will be measured from non-fasted venous blood samples.
NfL concentrations (pg/mL) will be quantified using enzyme-linked immunosorbent assay (ELISA).
Change in NfL will be calculated as the difference between post-intervention and baseline serum concentrations.
Higher concentrations indicate greater neuroaxonal injury.
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Baseline (Day 0), Post-trial (Day 14)
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Change in Serum Interleukin-1 Beta (IL-1β)
Zeitfenster: Baseline (Day 0), Post-trial (Day 14)
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Serum interleukin-1 beta (IL-1β) will be measured from non-fasted venous blood samples.
IL-1β concentrations (pg/mL) will be quantified using enzyme-linked immunosorbent assay (ELISA).
Change in IL-1β will be calculated as the difference between post-intervention and baseline serum concentrations.
Higher concentrations indicate greater systemic inflammation.
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Baseline (Day 0), Post-trial (Day 14)
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Change in Serum Tumor Necrosis Factor-Alpha (TNF-α)
Zeitfenster: Baseline (Day 0), Post-trial (Day 14)
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Serum Tumor Necrosis Factor-Alpha (TNF-α) will be measured from non-fasted venous blood samples.
TNF-α concentrations (pg/mL) will be quantified using enzyme-linked immunosorbent assay (ELISA).
Change in TNF-α will be calculated as the difference between post-intervention and baseline serum concentrations.
Higher concentrations indicate greater systemic inflammation.
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Baseline (Day 0), Post-trial (Day 14)
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Change in Wind-Up Ratio (WUR)
Zeitfenster: Baseline (Day 0), Pre/post each treatment session (Days 1-13), Post-trial (Day 14)
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Wind-up ratio (WUR), will be assessed using responses to repeated pinprick stimuli.
Change in WUR will be calculated as the difference between post-intervention and baseline measurements.
Lower WUR values indicate reduced temporal summation and decreased central sensitization.
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Baseline (Day 0), Pre/post each treatment session (Days 1-13), Post-trial (Day 14)
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Change in Conditioned Pain Modulation (CPM)
Zeitfenster: Baseline (Day 0), Post-trial (Day 14)
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Conditioned pain modulation (CPM), will be assessed using a cold pressor conditioning stimulus (1 to 4°C for 60 seconds) and pressure pain threshold (PPT) testing on the forearm.
The CPM effect will be calculated as the percent change in PPT from before to after the conditioning stimulus (%ΔPPT).
Higher CPM values indicate greater endogenous pain inhibition.
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Baseline (Day 0), Post-trial (Day 14)
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Marlon L. Wong, PT, PhD, University of Miami
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- 20260653
- 1R21NS149935-01 (US NIH Stipendium/Vertrag)
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IPD-Sharing-Zeitrahmen
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Art der unterstützenden IPD-Freigabeinformationen
- STUDIENPROTOKOLL
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Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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