Efficacy of Transcranial Magnetic Stimulation (TMS) in Central Post Stroke Pain ( CPSP)
Efficacy of Navigated Repetitive Transcranial Magnetic Stimulation in Treatment of Central Post Stroke Pain
調査の概要
状態
条件
詳細な説明
Central post stroke pain is often very resistant to treatment. TMS has been shown to be a promising tool in treating difficult pain conditions. The best sites for stimulation are still not known and navigation has been used only in few studies.
The aim is to evaluate the analgesic effects of Navigated Repetitive Transcranial Magnetic Stimulation ( nrTMS ) on pain in a three armed crossover study. The navigation is done by using magnetic resonance imaging and stereotactic camera system. The three arms include stimulation to M1, S2 and sham stimulation to M1. 10 Hz repetitive stimulation is given to a specified location once a day 5 days a week for two weeks in each of the three arms. A months washout period is kept between each arm of the study.
Pain and other variables are followed before, during and after the study for 6 months.
研究の種類
入学 (実際)
段階
- 適用できない
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- MRI defined brain infarction or hemorrhage before or at the age of 65 years
- CPSP diagnostic criteria is met (definite), verified by a neurologist
- Stable analgesic medication
- Average pain NRS 4 or more
Exclusion Criteria:
- Epilepsy
- Difficult aphasia
- Dementia
- Contraindication for TMS or MRI
- Alcohol and/or drug abuse
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:クロスオーバー割り当て
- マスキング:トリプル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:Transcranial Magnetic Stimulation I
Intervention: Repetitive navigated Transcranial Magnetic Stimulation of the motor cortex
|
Navigated repetitive transcranial magnetic stimulation of the motor cortex ( 10 Hz ) ,5 daily sessions per week for two weeks.
他の名前:
|
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実験的:Transcranial Magnetic Stimulation II
Intervention: Repetitive navigated Transcranial Magnetic Stimulation of the secondary somatosensory cortex
|
Navigated repetitive transcranial magnetic stimulation of the secondary somatosensory cortex ( 10 Hz ), 5 daily sessions per week for two weeks
他の名前:
|
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偽コンパレータ:Sham Stimulation
Intervention: Repetitive sham Transcranial Magnetic Stimulation with SHAM block of the motor cortex
|
Repetitive SHAM transcranial magnetic stimulation of the motor cortex ( 10Hz) 5 daily sessions per week for two weeks.
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in average pain compared to baseline
時間枠:1 month after each arm of the study
|
Patients will keep a pain diary for one week before stimulation and for two weeks after the stimulation.
A nurse will call the patient one month after the last stimulation.
|
1 month after each arm of the study
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Quality of life (EQ-5D)
時間枠:One week after each arm of the study and 6 months after the last one
|
Questionnaire EQ-5D
|
One week after each arm of the study and 6 months after the last one
|
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Depression
時間枠:One week after each arm of the study and 6 months after the last stimulation
|
Questionnaire
|
One week after each arm of the study and 6 months after the last stimulation
|
|
Change in average pain compared to baseline
時間枠:2,3,4,5 and 6 months after the last stimulation
|
Phone call ( Numeric Rating Scale (NRS) in rest and movement )
|
2,3,4,5 and 6 months after the last stimulation
|
|
Magnetoencephalography (MEG)
時間枠:One week before and after each arms stimulations
|
Changes in the irritability of the motor cortex and somatosensory cortex
|
One week before and after each arms stimulations
|
|
Number of patients with adverse effects
時間枠:From the start to the end of the study, on average 12 months per patient.
|
Adverse effects are followed actively
|
From the start to the end of the study, on average 12 months per patient.
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Hands´ motor function and dexterity
時間枠:One week before and after each arm of the study
|
Nine hole peg, Pinch and Jamar
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One week before and after each arm of the study
|
|
Cold water test
時間枠:One week before and after each arm of the study
|
Conditioned pain modulation (CPM)
|
One week before and after each arm of the study
|
|
Genetics
時間枠:No time frame, just a blood sample
|
Evaluation of genetical properties in terms of TMS related pain reduction
|
No time frame, just a blood sample
|
協力者と研究者
捜査官
- 主任研究者:Eija Kalso, PhD, Prof.、Professor of Pain Research and Management, University of Helsinki. Director of the Multidisciplinary Pain Clinic, Department of Anaesthesia and Intensive Care Medicine Helsinki University Central Hospital
- スタディチェア:Jyrki Mäkelä, MD, PhD、Head of laboratory, BioMag, Helsinki University Central Hospital
- スタディチェア:Erika Kirveskari, MD, PhD、Head and Chief Physician of Clinical Neurophysiology at Medical Imaging Center, Helsinki University Hospital
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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