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
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Marlon L Wong, PT, PhD
- Número de teléfono: 3052842670
- Correo electrónico: mwong2@miami.edu
Copia de seguridad de contactos de estudio
- Nombre: Richard Martinez, MS
- Número de teléfono: 305-284-2359
- Correo electrónico: rxm1388@med.miami.edu
Ubicaciones de estudio
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Florida
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Miami, Florida, Estados Unidos, 33136
- Christine E Lynn Rehabilitation Center
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Contacto:
- Marlon L Wong, PT, PhD
- Correo electrónico: mwong2@miami.edu
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Investigador principal:
- Marlon L. Wong, PT, PhD
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Contacto:
- Richard A Martinez, MS
- Número de teléfono: 305-284-2359
- Correo electrónico: rxm1388@med.miami.edu
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Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
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
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
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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.
Otros nombres:
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Sin intervención: 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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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change in Short Interval intraCortical Inhibition (SICI)
Periodo de tiempo: 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)
Periodo de tiempo: (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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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change in Neuropathic Pain Symptom Severity (NPSI)
Periodo de tiempo: 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)
Periodo de tiempo: 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)
Periodo de tiempo: 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)
Periodo de tiempo: 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)
Periodo de tiempo: 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)
Periodo de tiempo: 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)
Periodo de tiempo: 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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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Marlon L. Wong, PT, PhD, University of Miami
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
Otros números de identificación del estudio
- 20260653
- 1R21NS149935-01 (Subvención/contrato del NIH de EE. UU.)
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Marco de tiempo para compartir IPD
Criterios de acceso compartido de IPD
Tipo de información de apoyo para compartir IPD
- PROTOCOLO DE ESTUDIO
- SAVIA
- CIF
- CÓDIGO_ANALÍTICO
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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