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Fibromyalgia (FM)NCT02146495

Targeted Limbic Self-modulation as a Potential Treatment for Patients Suffering From Fibromyalgia

A study testing Simultaneous EEG and fMRI recordings and Amygdala-Electrical Fingerprint (Amyg-EFP)-NF Trial in people with Fibromyalgia (FM), run by Tel-Aviv Sourasky Medical Center at 1 site in Israel.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this study is to test whether voluntary regulation of limbic system activation is possible in patients with fibromyalgia and to examine the neurobehavioral effects of specific neuromodulation of this circuit on somatosensory, limbic, and cognitive processes. Read more about this study

Who is it for?
Ages 18 to 55 years
Conditions the study is for
Fibromyalgia (FM)
What is being tested?
Simultaneous EEG and fMRI recordings and Amygdala-Electrical Fingerprint (Amyg-EFP)-NF Trial
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
70 participants
Where
1 siteIsrael
Study dates
Jan 2017to Aug 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 55 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Age: 18-55
  • Fibromyalgia diagnosis by a specialist in internal medicine, Neurology or Pain medicine
  • Subjective complaints about sleep disorder
  • Pain does not stop despite regular medication- at least three events per week of pain ranked five out of ten
  • chronic drug treatment should not be change in the near future (6 weeks).
  • Hebrew speaker
  • Accepted criteria for MRI scan for medical use will be followed, according to the procedures prescribed in the MRI institute of the Tel-Aviv Sourasky medical center.

Who cannot join

  • Non-Hebrew speakers
  • Diagnosis of another pain chronic syndrome or any significant medical illness.
  • History of psychiatric or neurological diseases requiring hospitalization.

Trial locations and contacts

1 site in 1 country.

Israel1 site
  • Tel Aviv Sourasky Medical Center

    Tel Aviv, N/A = Not Applicable

Other trials in Israel

About this study

Official title: Mechanistic Perspective on EEG Based Amygdala Driven NF in Fibromyalgia

The goal of this study is to test whether voluntary regulation of limbic system activation is possible in patients with fibromyalgia and to examine the neurobehavioral effects of specific neuromodulation of this circuit on somatosensory, limbic, and cognitive processes. This goal will be achieved by using a method previously developed for the construction of an fMRI-enriched EEG model ("EEG-Finger-Print", EFP) that selectively targets the amygdala BOLD activation (Amyg-EFP). The investigators conducted two studies: In the first study, the investigators conducted simultaneous recordings of EEG and fMRI during Amyg-EFP NF training on patients with FM. The main objective is to demonstrate target engagement following Amyg-EFP-NF training in FM patients. In the second study, the investigators aim to conduct a randomized clinical trial to examine the causal effect of the Amyg-EFP NF trial. The investigators will compare neurobehavioral effects between three groups. I. Amyg-EFP-NF group: a multisession NF trial using the Amyg-EFP model. II. Control group 1- sham-NF: a multisession NF trial using sham feedback. III. Control group 2: patients in this group will continue their usual treatment without intervention.

Read the detailed description

The current study aims to focus on the neural mechanism and brain-guided therapy of Fibromyalgia (FM); a chronic pain syndrome. Despite intense investigations, the pathophysiology of fibromyalgia remains elusive. Several studies demonstrated that morphological and functional changes in the central nervous system may play an important role in FM development and progression. The unknown etiopathology of FM contributed greatly to the absence of mechanism-specific cures. The insufficient treatment for FM, along with the understanding that CNS abnormality constitutes a major factor in FM pathophysiology, emphasizes the need for mechanism-based therapeutic intervention and opens the door for advanced neuromodulation techniques. Guided by this approach, the investigators aspired to establish a multi-function model with the potential to exert neuromodulation effects. To address this goal, the investigators employ a method previously developed for the construction of an fMRI-enriched EEG model ("EEG-Finger-Print", EFP). In this approach, EEG is used to predict specific brain activity, as measured by fMRI in a given region. Our main objective is to explore the neural mechanisms that underlie limbic neuromodulation and to gain a profound understanding of the functional processes that can potentially modify deficient functions in FM. The investigators intend to conduct two studies. In the first study, the investigators focus on the previously developed EFP model that selectively targets the amygdala BOLD activation (Amyg-EFP). The investigators aspired to investigate Amyg-EFP-NF effects on chronic pain in FM. To do so, the investigators conducted simultaneous recordings of EEG and fMRI during Amyg-EFP NF training on patients with FM. The main research objective of this study is to demonstrate target engagement following Amyg-EFP-NF training in FM patients. In the second study, the investigators aim to conduct a randomized clinical trial to examine the causal effect of the Amyg-EFP on patients with FM and to explore the clinical effect of this model on a wide range of symptoms related to FM. To examine the neural, clinical, and behavioral specific effects of the EFP-NF training, the investigators will implement a comprehensive clinical assessment. Furthermore, the investigators will conduct an MRI/fMRI scan before and after the EFP-NF trial, in order to explore the neural modification effects. Clinical follow-up will be conducted after 10-12 months from the post-intervention evaluation. The investigators will compare the neural, clinical, and behavioral effects between three groups. I. Amyg-EFP-NF group: a multisession NF trial using feedback driven by the Amyg-EFP model. II. Control group I- sham-NF: a multisession NF trial using sham feedback. III. Control group II: patients in this group will continue their usual treatment without any intervention. The investigators hypothesize that patients in the Amyg -EFP-NF group will exhibit wider and more robust changes in neural and behavioral outcomes associated with the wide range of symptoms related to FM. This study can significantly advance the understanding of the neural processes that mediate modification of somatic-affective functions in patients with FM and, therefore, enable the establishment of better treatment prediction and possibly more personalized procedures in future studies.

Being tested
Simultaneous EEG and fMRI recordings, Amygdala-Electrical Fingerprint (Amyg-EFP)-NF Trial, Amygdala-Electrical Fingerprint (Amyg-EFP)-NF Sham Trial
Keywords
Fibromyalgia, neurofeedback, fMRI, EEG
Medical subject headings
Fibromyalgia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Simultaneous EEG and fMRI recordingsDevice

  • Amygdala-Electrical Fingerprint (Amyg-EFP)-NF TrialDevice

    Neurofeedback training utilizing Amygdala Electrical Fingerprint (Amyg-EFP) methodology

  • Amygdala-Electrical Fingerprint (Amyg-EFP)-NF Sham TrialDevice

    Sham neurofeedback training based on a randomized artificial Amyg-EFP signal.

Study groups in NCT02146495
Study groupRoleWhat they receive
Simultaneous EEG/ fMRI Recordings during Amyg-EFP-NFExperimentalPatients with FM will undergo concurrent EEG and fMRI recordings. During the fMRI scans, they will engage in Amyg-EFP NF training.
Receives: Device: Simultaneous EEG and fMRI recordings
Amyg-EFP-NF TrialActive comparatorThe EFP-NF procedure will include a multisession NF trial (10 sessions) using feedback driven by the Amyg-EFP model.
Receives: Device: Amygdala-Electrical Fingerprint (Amyg-EFP)-NF Trial
Amyg-EFP-NF Sham TrialSham comparatorThe sham NF procedure will include a multisession NF trial (10 sessions) using sham feedback; in this condition, the feedback will be provided based on a randomized Amyg-EFP signal.
Receives: Device: Amygdala-Electrical Fingerprint (Amyg-EFP)-NF Sham Trial
Treatment As UsualNo interventionPatients in this group will continue their usual treatment without any intervention. Patients in this control group will undergo a complete clinical and neural evaluation at the beginning and end of a defined period, similar to the NF intervention period, and a clinical follow-up (after 10-12 months).

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Clinical improvement using the Fibromyalgia Impact Questionnaire (FIQ) to evaluate FM symptoms

    Scoring from 0 (no impairment) to 80 (maximum), with subscales ranging up to 10 (maximum).

    Measured: Immediately post-intervention relative to the baseline level

  2. Clinical improvement using the Symptom Severity Score (SSS)

    Ranges from 0 to 12 (highest severity).

    Measured: Immediately post-intervention relative to the baseline level

  3. Clinical improvement using the Widespread Pain Index (WPI)

    Ranges from 0 to 19 (highest level of pain distribution).

    Measured: Immediately post-intervention relative to the baseline level

  4. Clinical improvement using the SF-36 Health Survey (SF-36) to evaluate daily impacts of FM

    Scores from 0 to 100 (higher scores indicate better health).

    Measured: Immediately post-intervention relative to the baseline level

  5. Clinical improvement using the Trait Anxiety Inventory (STAI-T) to evaluate the level of anxiety

    Ranges from 20 to 80 (highest anxiety level).

    Measured: Immediately post-intervention relative to the baseline level

  6. Clinical improvement using the Beck Depression Inventory (BDI) to evaluate the level of depression

    Ranges from 0 to 63 (highest depression level).

    Measured: Immediately post-intervention relative to the baseline level

  7. Long-term clinical improvement using the Fibromyalgia Impact Questionnaire (FIQ) to evaluate FM symptoms

    Scoring from 0 (no impairment) to 80 (maximum), with subscales ranging up to 10 (maximum).

    Measured: Change in symptoms at 10-12 months relative to the baseline level (Follow-up measure vs. Baseline)

  8. Long-term clinical improvement using the Symptom Severity Score (SSS)

    Ranges from 0 to 12 (highest severity).

    Measured: Change in symptoms at 10-12 months relative to the baseline level (Follow-up measure vs. Baseline)

  9. Long-term clinical improvement using the Widespread Pain Index (WPI)

    Ranges from 0 to 19 (highest level of pain distribution).

    Measured: Change in symptoms at 10-12 months relative to the baseline level (Follow-up measure vs. Baseline)

  10. Long-term clinical improvement using the SF-36 Health Survey (SF-36) to evaluate daily impacts of FM

    Scores from 0 to 100 (higher scores indicate better health).

    Measured: Change in symptoms at 10-12 months relative to the baseline level (Follow-up measure vs. Baseline)

  11. Long-term clinical improvement using the Trait Anxiety Inventory (STAI-T) to evaluate the level of anxiety

    Ranges from 20 to 80 (highest anxiety level).

    Measured: Change in symptoms at 10-12 months relative to the baseline level (Follow-up measure vs. Baseline)

  12. Long-term clinical improvement using the Beck Depression Inventory (BDI) to evaluate the level of depression

    Ranges from 0 to 63 (highest depression level).

    Measured: Change in symptoms at 10-12 months relative to the baseline level (Follow-up measure vs. Baseline)

Secondary outcomes (1)
  1. Neural Prediction

    Simultaneous fMRI/EEG scan in order to identify whether the Amyg-EFP signal reliably predicts the amygdala BOLD activity

    Measured: Through study completion, an average of 2 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 May 2014 (estimated)
  2. Study startJan 2017
  3. Primary completionAug 2022
  4. Study completionAug 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
70 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02146495
Sponsor's protocol ID
TASMC-14-HS-0044-CTIL
Status last verified
Feb 2024
First submitted
21 May 2014
Last updated
20 Mar 2024
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Or-Borichev A, Lerner Y, Hamrani Y, Gurevitch G, Mor N, Doron M, Sarna N, Ablin JN, Hendler T, Sharon H. Targeted limbic self-neuromodulation for alleviating central sensitization symptoms in fibromyalgia. BMC Med. 2025 May 28;23(1):304. doi: 10.1186/s12916-025-04138-3.

    PubMed 40437546

Questions about this trial

What is this clinical trial studying?

A study testing Simultaneous EEG and fMRI recordings and Amygdala-Electrical Fingerprint (Amyg-EFP)-NF Trial in people with Fibromyalgia (FM), run by Tel-Aviv Sourasky Medical Center at 1 site in Israel.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Mar 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Israel. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Clinical improvement using the Fibromyalgia Impact Questionnaire (FIQ) to evaluate FM symptoms (time frame: Immediately post-intervention relative to the baseline level). The study lists 12 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02146495, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Mar 2024.

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