The Clinical Effect of Low-Intensity Electromagnetic Field Neurostimulation in Fibromyalgia Syndrome Patients

This study has been completed.
Sponsor:
Collaborator:
Kettering University
Information provided by (Responsible Party):
Jeffrey B. Hargrove, McLaren Regional Medical Center
ClinicalTrials.gov Identifier:
NCT01180244
First received: August 10, 2010
Last updated: May 30, 2014
Last verified: May 2014
  Purpose

The purpose of this study is to determine whether persons treated with a low-intensity, noninvasive form of cortical electrical stimulation experience a reduction in symptoms of fibromyalgia different than persons receiving a sham treatment. Outcome measures include reduction in patient pain levels and improvement in sleep measures.


Condition Intervention
Fibromyalgia
Device: Noninvasive cortical electrical stimulation
Device: Sham treatment

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: The Clinical Effect of Low-Intensity Electromagnetic Field Neurostimulation in Fibromyalgia Syndrome Patients

Resource links provided by NLM:


Further study details as provided by McLaren Regional Medical Center:

Primary Outcome Measures:
  • Change in Tender Point Pain Threshold [ Time Frame: Total timeframe 13 weeks: baseline followed by 11 weeks of treatment with outcome assessed within 14 days following end of treatment ] [ Designated as safety issue: No ]
    Tender point pain threshold is derived by summing the dolorimetry-based pain pressure thresholds measured on a subject for each of the 18 tender points sites specified by the American College of Rheumatology for fibromyalgia classification. The range of dolorimeter values for each tender point site is 0-4 (units are kilograms per square centimeter, i.e. kg/cm^2). Higher numbers represent greater pressure required to elicit pain, and are thus indicators of "less pain" sensitivity at the tender point. Since 18 tender points are measured on a patient and their individual dolorimeter values summed, the range of tender point pain threshold values is 0-72. A higher score represents less overall pain sensitivity. The change in tender point pain threshold is determined by subtracting values at baseline from values at end of treatment. Thus a positive difference represents pain improvement (i.e.. a better outcome). A negative difference represents pain worsening (i.e. a worse outcome).


Secondary Outcome Measures:
  • Change in Number of Positive Tender Points [ Time Frame: Total timeframe 13 weeks: baseline followed by 11 weeks of treatment with outcome assessed within 14 days following end of treatment ] [ Designated as safety issue: No ]
    The number of positive tender points ranges from 0-18, and are defined per criteria set forth by the American College of Rheumatology and based on dolorimetry measurements made on 18 prescribed tender point locations. A tender point is considered "positive" if less than 4 kilograms per centimeter squared pressure is required to elicit a painful response. The change in number of positive tender points is determined by subtracting the number of positive tender points at baseline from the number of positive tender points at end of treatment. Thus, a negative number represents pain improvement (i.e. better outcome), whereas a positive number represents a worsening of pain (i.e. worse outcome).

  • Change in Fibromyalgia Impact Questionnaire Overall Score [ Time Frame: Total timeframe 13 weeks: baseline followed by 11 weeks of treatment with outcome assessed within 14 days following end of treatment ] [ Designated as safety issue: No ]
    The Fibromyalgia Impact Questionnaire yields a score ranging from 0 to 100, with higher scores representing a greater impact or level of symptoms. The change in Fibromyalgia Impact Questionnaire is determined by subtracting scores at baseline from scores at end of treatment. Thus negative numbers represent symptom improvement (i.e. a better outcome) and positive numbers represent symptom worsening (i.e. a worse outcome).

  • Change in Fibromyalgia Impact Questionnaire Pain Visual Analog Scale [ Time Frame: Total timeframe 13 weeks: baseline followed by 11 weeks of treatment with outcome assessed within 14 days following end of treatment ] [ Designated as safety issue: No ]
    The Fibromyalgia Impact Questionnaire includes a pain visual analog scale (VAS) with ranges of 0-10 centimeters. Higher values represent greater pain. The change in Fibromyalgia Impact Questionnaire pain visual analog scale is determined by subtracting baseline VAS values from end of treatment VAS values. Thus, a negative value represents pain improvement (i.e. a better outcome), while a positive value represents pain worsening (i.e. a worse outcome).

  • Change in Fibromyalgia Impact Questionnaire Sleep Satisfaction Visual Analog Scale [ Time Frame: Total timeframe 13 weeks: baseline followed by 11 weeks of treatment with outcome assessed within 14 days following end of treatment ] [ Designated as safety issue: No ]
    The Fibromyalgia Impact Questionnaire includes a sleep visual analog scale (VAS) with ranges of 0-10 centimeters. Higher values represent greater difficulty with sleep. The change in Fibromyalgia Impact Questionnaire sleep visual analog scale is determined by subtracting baseline VAS values from end of treatment VAS values. Thus, a negative value represents sleep improvement (i.e. a better outcome), while a positive value represents sleep worsening (i.e. a worse outcome).


Enrollment: 91
Study Start Date: January 2002
Study Completion Date: July 2008
Primary Completion Date: January 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Active treatment
Subjects in this group will receive the noninvasive cortical stimulation signal from the treatment device
Device: Noninvasive cortical electrical stimulation
Subjects will receive 22 sessions of the intervention protocol, twice per week for a total of 11 weeks. The signal stimulation used in this study utilizes amplitude modulation to shape a high frequency carrier signal, nominally greater than 10 kilohertz, into the form of one or more low frequency components, nominally less than 40 hertz. Exact protocol is set in software and is the same for all participants in the active treatment arm.
Other Name: NeuroPoint
Placebo Comparator: Placebo group
Subjects in this group will be provided the same experience as those in the active treatment arm, but will not receive the noninvasive cortical stimulation signal from the treatment device
Device: Sham treatment
Subjects in the placebo group will receive the exact same experience as those in the active treatment group. However, the device will not output any electrical stimulation signal.
Other Name: NeuroPoint

Detailed Description:

There is increasing acceptance that pain in fibromyalgia is a result of dysfunctional sensory processing in the spinal cord and brain. Electrical cortical stimulation is a device-based form of therapy that is increasingly being considered as an adjuvant to current medical modalities for the treatment of chronic pain conditions such as fibromyalgia. The investigators propose that stimulation of cortical areas believed to be involved in dysfunctional sensory processing may have a beneficial influence on fibromyalgia symptoms.

The aim of this randomized double blind, placebo controlled study is to evaluate the efficacy, safety, and tolerability of noninvasive cortical stimulation in the management of fibromyalgia symptoms. More specifically, an active treatment group of subjects will receive the study's cortical stimulation protocol twice a week for 11 weeks and will be evaluated within 14 days following end of treatment, for a total timeframe of 13 weeks. In comparison, a similar group of subjects will receive the same treatment protocol without the actual stimulation signal being applied. The signal utilized is a modulated form that permits very low-intensity signals to pass through outer tissues with less attenuation due to tissue impedance. The signals are of a sufficiently low strength that they are below the level of perception. Hence subjects cannot feel the signal, and are therefore blinded to treatment arm. Investigators and clinical staff are also blinded. Outcome measures include post-treatment to baseline changes in tender points, sleep characteristics as measured by visual analog scales, and outcomes instruments including the Fibromyalgia Impact Questionnaire.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 18 through 65 years
  • An ability to read and comprehend English
  • Completion of a minimum of grade 8 education
  • Diagnosis of fibromyalgia in 1999 or earlier, by a rheumatologist or appropriate specialist, and currently meeting the American College of Rheumatology 1990 criteria
  • Symptoms for at least 48 months with no recent remission of symptoms to any degree

Exclusion Criteria:

  • Developmental disabilities, or significant psychological disorder (except depression and anxiety disorders) for which treatment has become necessary
  • A history of chronic infection or chronic condition such as lupus, rheumatoid arthritis, Parkinson's Disease, multiple sclerosis, hepatitis, history of meningo-encephalitis, polio, seizures, or metastatic cancer
  • Current pregnancy, or plans to become pregnant during the study period.
  • Any other condition deemed to pose a risk to the patient at the discretion of the investigators
  • Exposure to other neurostimulation systems, or electroconvulsive therapy
  • Any implantable electronic device
  • Any present or previous litigation regarding their physical condition
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01180244

Locations
United States, Michigan
McLaren Regional Medical Center
Flint, Michigan, United States, 48532
Sponsors and Collaborators
McLaren Regional Medical Center
Kettering University
Investigators
Principal Investigator: Jeffrey B Hargrove, PhD Kettering University
Principal Investigator: Susan J Smith, MD McLaren Regional Medical Center
Principal Investigator: Sunil Nagpal, MD McLaren Regional Medical Center
Principal Investigator: David G Simons, MD Emory University
  More Information

No publications provided

Responsible Party: Jeffrey B. Hargrove, Principal Investigator, McLaren Regional Medical Center
ClinicalTrials.gov Identifier: NCT01180244     History of Changes
Other Study ID Numbers: 113
Study First Received: August 10, 2010
Results First Received: March 19, 2014
Last Updated: May 30, 2014
Health Authority: United States: Institutional Review Board

Keywords provided by McLaren Regional Medical Center:
fibromyalgia
noninvasive
electrical
cortical
stimulation
pain
brain
tender point

Additional relevant MeSH terms:
Fibromyalgia
Myofascial Pain Syndromes
Muscular Diseases
Musculoskeletal Diseases
Rheumatic Diseases
Neuromuscular Diseases
Nervous System Diseases

ClinicalTrials.gov processed this record on August 28, 2014