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Peripheral Electrical Stimulation for Migraine Prevention

26 januari 2021 uppdaterad av: 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.

Studieöversikt

Status

Okänd

Betingelser

Studietyp

Interventionell

Inskrivning (Förväntat)

120

Fas

  • Inte tillämpbar

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

20 år till 65 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Sham Comparator: Sham stimulering
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.
Experimentell: Aktiv stimulering
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.
Inget ingripande: hälsosam kontroll

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
change in migraine or headache days of a month in average
Tidsram: 2 months
change in migraine or headache days of a month in average
2 months
responder rate
Tidsram: 2 months
responder rate (50% pain reduction from baseline)
2 months

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
change in moderate to severe headache days of a month in average
Tidsram: 2 months
2 months
acute headache medication use
Tidsram: 2 months
2 months
Beck Depression Inventory
Tidsram: 2 months
2 months
modified Migraine Disability Scale
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 2 months
functional connectivity change of EEG before and after treatment
2 months
fMRI change after treatment
Tidsram: 2 months
functional connectivity change of fMRI before and after treatment
2 months
MRI change after treatment
Tidsram: 2 months
VBM changes of MRI before and after treatment
2 months

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Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Förväntat)

1 februari 2021

Primärt slutförande (Förväntat)

30 juni 2022

Avslutad studie (Förväntat)

31 december 2022

Studieregistreringsdatum

Först inskickad

2 april 2019

Först inskickad som uppfyllde QC-kriterierna

2 april 2019

Första postat (Faktisk)

3 april 2019

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

29 januari 2021

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

26 januari 2021

Senast verifierad

1 januari 2021

Mer information

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