Spinal Cord Stimulation and Functional MRI
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Purpose
The overall objective of this study is to assess patterns of fMRI cortical activation with spinal cord stimulation (SCS) in patients with neuropathic leg pain and therefore define cortical correlates, as well as to investigate cortical representations of pain and pain relief and the interactions therein, in the setting of neuropathic leg pain and SCS.
| Condition |
|---|
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Complex Regional Pain Syndrome (CRPS) Neuropathic Leg Pain |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
| Official Title: | Investigating the Cortical Correlates of Spinal Cord Stimulation Using Functional Magnetic Resonance Imaging |
- Effects of spinal cord stimulation on patients with neuropathic leg pain through fMRI analysis [ Time Frame: 1 year ] [ Designated as safety issue: No ]We are analyzing the data from fMRI scans to understand more the functional activation of the cerebral cortex
| Estimated Enrollment: | 10 |
| Study Start Date: | September 2011 |
| Estimated Study Completion Date: | January 2015 |
| Estimated Primary Completion Date: | January 2014 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
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functional MRI testing
fMRI scanning with SCS "on" and "off" at different settings.
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Detailed Description:
The main objective is to define, using functional magnetic resonance imaging, the effects of spinal cord stimulation (SCS) on cortical and subcortical BOLD effects in patients with neuropathic leg pain. Our hypothesis is that SCS will demonstrate a consistent pattern of BOLD activation that will correlate with symptomatic improvement.
Eligibility| Ages Eligible for Study: | 18 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Patients with implanted spinal cord stimulators
Inclusion Criteria:
- Age 18-55 years at time of enrollment.
- Have previous implantation of thoracic epidural Medtronic Restore Ultra, Prime Advanced and Restore Advanced SCS in place for the treatment of CPRS-type 1 or chronic refractory neuropathic leg pain following FBSS. The implantation must be 3 or more months prior to enrollment.
- Patient must have reported significant pain improvement (>50%) following implantation of the SCS.
- Have consistently reproducible pain relief (> 50%) within 10 minutes of switching SCS from an OFF state to an ON state (with "optimal" parameters - see below).
- The SCS battery is implanted in the buttocks region.
- Unilateral or bilateral extremity pain.
- Able to provide informed consent.
Exclusion Criteria:
- Contraindication to MRI such as: SCS lead in the cervical epidural region Cardiac pacemaker Intracranial aneurysm clips, metallic implants or external clips within 10mm of the head Metallic foreign metals within the orbits Pregnancy; (urine pregnancy test will be done to confirm) Claustrophobia
- Pattern of response to spinal cord stimulation Inconsistent response of pain to spinal cord stimulation Long interval (> 10 minutes) before pain relief following switching SCS from an OFF state to an ON state (with "optimal" parameters) - long "washout" period Lack of significant pain improvement (< 50%) following implantation of SCS
- Positive history of significant brain lesions or pathology including:
- Prior ablative neurosurgery
- History of large vessel strokes or brain tumors
- Psychological Screening
Contacts and Locations| Contact: Phuong Nguyen | 614-366-6952 | phuong.nguyen2@osumc.edu |
| United States, Ohio | |
| The Ohio State Medical Center | Recruiting |
| Columbus, Ohio, United States, 43210 | |
| Contact: Phuong Nguyen 614-366-6952 phuong.nguyen2@osumc.edu | |
| Principal Investigator: Ali Rezai, MD | |
| Principal Investigator: | Ali Rezai, MD | Ohio State University |
More Information
No publications provided
| Responsible Party: | Ali Rezai, MD, Professor of Neurological Surgery, The Ohio State University |
| ClinicalTrials.gov Identifier: | NCT01512121 History of Changes |
| Other Study ID Numbers: | 2011H0040 |
| Study First Received: | January 11, 2012 |
| Last Updated: | May 14, 2013 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Complex Regional Pain Syndromes Autonomic Nervous System Diseases Nervous System Diseases Peripheral Nervous System Diseases Neuromuscular Diseases |
ClinicalTrials.gov processed this record on May 23, 2013