Assessment of a Specific Neurophysiological Brain Pattern in Patients Suffering From Chronic Back Pain

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00744575
Recruitment Status : Completed
First Posted : September 1, 2008
Last Update Posted : October 11, 2010
Information provided by:
University Hospital Freiburg

Brief Summary:
The purpose of this study is whether patients suffering from chronic back pain for more than one year will show a specific neurophysiological pattern in the EEG. This pattern is referred to as Thalamo-Cortical Dysrhythmia (TCD) and consists most likely of a self sustaining loop between the Cortex and Thalamus. This pattern has been found before in patients with very severe chronic pain. Specific lesions to the Thalamus result in a reduction of this pattern and decrease in pain. With this study the investigators will assess whether this pattern can be found in back pain patients of different types. Patients will be measured by EEG for the existence of TCD and will undergo detailed pain and psychological diagnostic.

Condition or disease
Back Pain

Detailed Description:

The neurophysiological processing of chronic pain is despite large efforts in the recent years still not well understood. However the so called cortical pain matrix describes cortical areas associated with the perception and processing of pain stimuli. Most studies identify second somatic area (SII), the insular regions, the anterior cingulated cortex (ACC) as well as the contralateral thalamus and the primary somatic area (SI) (Peyron, Laurent & Garcia-Larrea, 2000) as areas related to pain processing. In two recent publications by a Swiss research group (Sarnthein, Stern, Aufenberg, Rousson & Jeanmonod, 2006; Stern, Jeanmonod & Sarnthein, 2006) a dynamical EEG in the cortex pattern is described which is obvious related to chronic neurogenic pain. This pattern consists of an increase in EEG power and a shift of the dominant peak towards lower frequencies, mainly high theta (6-9 Hz). Source localization demonstrates that this overactivation mainly takes place in the areas of the cortical pain matrix. The authors argue that this pattern termed thalamocortical dysrhythmia is due to a thalamocortical loops initiated from the central lateral nucleus in the thalamus. This hypothesis is supported by the effects of a therapeutic lesion within the thalamus which led to (a) pain relief of 95% and to (b) the disappearance of the dysrhythmic pattern described above.

The investigators will set out to conduct a observational trial in order to determine pain related EEG characteristics in patients suffering from chonic back pain. Twenty four patients will be recruited for the study. A 64 channel high-resolution EEG and the following parameter will be recorded: Neuropathic Pain Questionnaire (Backonja and Krause 2003), EuroQol, BSI, Graded hronic pain scale(Klasen, Hallner, Schaub, Willburger & Hasenbring, 2004)pain (McGill Pain Questionnaire, VAS pain), and generic quality of life (Fragebogen zur Lebenszufriedenheit, Henrich & Herschbach, 1996).

An age and sex matched control group of healthy participants will be measured with the same method in order to compare whether the patients show a dysrhythmia pattern.

Study Type : Observational
Estimated Enrollment : 72 participants
Observational Model: Case Control
Time Perspective: Prospective
Official Title: Assessment of a Specific Neurophysiological Brain Pattern in Patients Suffering From Chronic Back Pain
Study Start Date : August 2008
Actual Primary Completion Date : June 2009
Actual Study Completion Date : June 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Back Pain

Chronic Back Pain
Healthy Sex & Age Matched Controls

Primary Outcome Measures :
  1. Difference in EEG signature and pain perception between groups [ Time Frame: 25 months ]

Secondary Outcome Measures :
  1. Quality of life, pain perception, neuropathic pain questionnaire, brief symptom inventory, life satisfaction [ Time Frame: 25 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
chronic back pain

Inclusion Criteria:

  • Chronic back pain of at least one year duration
  • Command of German language
  • Age 18-70

Exclusion Criteria:

  • Psychiatric disorders
  • Immune suppression

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00744575

University Medical Center Freiburg
Freiburg, Germany, 79106
Sponsors and Collaborators
University Hospital Freiburg
Principal Investigator: Stefan M Schmidt, PhD Universtiy Medical Center Freiburg

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: PhD Stefan Schmidt, University Hospital Freibung Identifier: NCT00744575     History of Changes
Other Study ID Numbers: 200/08
First Posted: September 1, 2008    Key Record Dates
Last Update Posted: October 11, 2010
Last Verified: January 2009

Keywords provided by University Hospital Freiburg:
back pain
chronic pain

Additional relevant MeSH terms:
Back Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms