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Transcranial Stimulation (tDCS) For the Treatment of Neuropathic Facial Pain (TDCS)

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ClinicalTrials.gov Identifier: NCT01849796
Recruitment Status : Terminated (Investigators moved to other institutions)
First Posted : May 9, 2013
Last Update Posted : December 10, 2015
Sponsor:
Information provided by (Responsible Party):
Beth Israel Medical Center

Brief Summary:
A study to determine if transcranial direct current stimulation (tDCS, the device that regulates brain activity, can improve pain in people with neuropathic facial pain and compare which modality (inhibitory tDCS over the somatosensory cortex or excitatory tDCS over the motor cortex) can result in better pain-relief.)

Condition or disease Intervention/treatment Phase
Facial Pain Device: tDCS Phase 2

Detailed Description:
This is a pilot study designed to collect preliminary data on safety and efficacy of transcranial direct current stimulation (tDCS)to relieve pain in subjects with neuropathic facial pain,and to compare two pain-treatment tDCS modalities: inhibitory tDCS stimulation over the somatosensory cortex and excitatory tDCS over the motor cortex.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 21 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: Transcranial Stimulation (TDCS) For The Treatment of Neuropathic Facial Pain.
Study Start Date : October 2010
Actual Primary Completion Date : December 2013
Actual Study Completion Date : December 2013

Arm Intervention/treatment
Active Comparator: Group A: Anodal tDCS
Group A will receive one block of real excitatory anodal tDCS over the motor cortex and one block of sham.
Device: tDCS
TDCS/sham will be delivered using the battery-operated device Phoresor II Auto with two saline-soaked sponge electrodes. To deliver excitatory (anodal) tDCS over the motor cortex, the main electrode will be placed over the motor cortex on the hemisphere contralateral to the major source of pain. The second electrode will be placed on the skin overlying the supraorbital region ipsilateral to the affected area. To deliver inhibitory (cathodal) tDCS, the main electrode will be placed over the somatosensory cortex on the hemisphere contralateral to the major source of pain. The second electrode will be placed on the skin overlying the supraorbital region ipsilateral to the affected area. The current will be delivered at the intensity of 2mA for 20 minutes. To deliver sham, the current will be delivered for 30 sec only to elicit tingling skin sensation but no cortical excitability changes.
Sham Comparator: Arm B: Cathodal tDCS
Group B will receive one block of inhibitory cathodal tDCS over the somatosensory cortex and one block of sham.
Device: tDCS
TDCS/sham will be delivered using the battery-operated device Phoresor II Auto with two saline-soaked sponge electrodes. To deliver excitatory (anodal) tDCS over the motor cortex, the main electrode will be placed over the motor cortex on the hemisphere contralateral to the major source of pain. The second electrode will be placed on the skin overlying the supraorbital region ipsilateral to the affected area. To deliver inhibitory (cathodal) tDCS, the main electrode will be placed over the somatosensory cortex on the hemisphere contralateral to the major source of pain. The second electrode will be placed on the skin overlying the supraorbital region ipsilateral to the affected area. The current will be delivered at the intensity of 2mA for 20 minutes. To deliver sham, the current will be delivered for 30 sec only to elicit tingling skin sensation but no cortical excitability changes.



Primary Outcome Measures :
  1. Primary outcome will be a composite measure "Pain intensity/consumption of pain medication". [ Time Frame: Daily from Baseline to up to 17 weeks ]
    The washout period between phase I and phase II of the study is variable as patients have to go back to their baseline.



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Ages Eligible for Study:   21 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Spontaneous facial neuropathic pain due to any of following:

    1. Trigeminal neuralgia, type 1, (TN1): facial pain of spontaneous onset with predominantly episodic pain.
    2. Trigeminal neuralgia, type 2, (TN2): facial pain of spontaneous onset with predominantly constant pain.
    3. Trigeminal neuropathic pain, (TNP): facial pain resulting from unintentional injury to the trigeminal system from facial trauma, oral surgery, ear, nose and throat (ENT) surgery, root injury from posterior fossa or skull base surgery, stroke, etc.
    4. Trigeminal deafferentation pain, (TDP): facial pain in a region of trigeminal numbness resulting from intentional injury to the trigeminal system from neurectomy, gangliolysis, rhizotomy, nucleotomy, tractotomy, or other denervating procedures.
    5. Symptomatic trigeminal neuralgia, (STN): facial pain resulting from multiple sclerosis.

    e) Postherpetic neuralgia, (PHN): facial pain resulting from trigeminal Herpes zoster (shingles) outbreak in the trigeminal distribution.

  • Pain intensity score for "worst pain in the last 24 hours" >4 on a numeric scale 0-10 at the time of enrollment and before the first stimulation of each treatment block.
  • Pain intensity score for "pain right now" >4 on a numeric scale 0-10 before the first stimulation of each block of treatment.

Exclusion Criteria:

  • Uncontrolled hypertension, uncontrolled diabetes, uncontrolled cardiovascular disease
  • Other painful conditions than neuropathic facial pain, that are not related to and can't be distinguished from the neuropathic facial pain
  • Pregnancy
  • Implanted neurostimulation devices (e.g. a spinal cord stimulator, a deep brain stimulator, etc)
  • Active illegal drug/alcohol abuse
  • Unable to follow directions or complete tools in English.

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 ClinicalTrials.gov identifier (NCT number): NCT01849796


Locations
United States, New York
Beth Israel Medical Center
New York, New York, United States, 10033
Sponsors and Collaborators
Beth Israel Medical Center
Investigators
Principal Investigator: Joy Hao, MD Beth Israel Medical Center

Additional Information:
Responsible Party: Beth Israel Medical Center
ClinicalTrials.gov Identifier: NCT01849796     History of Changes
Other Study ID Numbers: 148-10
First Posted: May 9, 2013    Key Record Dates
Last Update Posted: December 10, 2015
Last Verified: December 2015

Keywords provided by Beth Israel Medical Center:
tDCS
Neuropathic
Facial
Pain
Neuralgia
deafferentation
Trigeminal

Additional relevant MeSH terms:
Facies
Facial Pain
Disease Attributes
Pathologic Processes
Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms