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Crohn's DiseaseDouleur IRMfNCT02874495

Anticipation Effect on Painful Phenomenons Linked to Rectal Distension for Patients With a Crohn's Disease in Remission

An observational study of Crohn's Disease, run by University Hospital, Grenoble at 1 site in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Crohn's disease goes along with an alteration of the quality of life, even in remission and has a negative impact on stress management linked to the pain and the health. Conversely, stress and psychological variables play a significant role in the pathogenesis of this disease. Read more about this study

Who is it for?
Ages 18 to 60 yearsHealthy volunteers can take part
Conditions the study is for
Crohn's Disease
What is being tested?
Psychological tests, Magnetic Resonance Imaging and Heart Rate Variability
How many people
44 participants
Where
1 siteFrance
Study dates
Jan 2012to Apr 2017
Phase
Observational
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 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Study population: Patients with Crohn's disease

Who may be able to join

  • For patients :
  • Patients over 18 years and less than 60 years.
  • Right-handed.
  • Diagnosis of Crohn's disease established on clinical biological, endoscopic and anatomopathological criteria.
  • Ideal localization and/or diarrhea of Crohn's Disease, with an absence of rectal or anoperineal ravages past or presents in order to not do distension on rectal/ and anoperineal lesions.
  • Crohn's disease treatment authorize : 5-aminosalicylates since at least 4 weeks with a stable dose since at least 2 weeks ; immunosuppressive drugs since at least 12 weeks with a stable dose since at least 4 weeks ; anti-TNF since at least 3 months with a stable dose since at least 1 month ; absence of corticosteroid treatment since at least 15 days.
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  • Clinical remission : Crohn's Disease Activity Index (CDAI) < 150 (Best 1976) and biological : normal CRP and faecal calprotectin < 100 g/g.
  • Patient able to understand and follow necessary commissions for the conduct of the clinical trial, and that have given his free written consent for this study.
  • Registered to a French social security.
  • The person won't be allow to participate simultaneously to another study and there won't be an exclusion period to participation to a clinical or therapeutic trial at the end of this study.
  • For healthy volunteers
  • Patients over 18 years and less than 60 years.
  • Right-handed.
  • Paired with patients for sex and age.
  • Absence of digestive surgical or medical history except appendectomy, hysterectomy, cholecystectomy, inguinal hernia cure and/or femoral.
  • Absence of digestive symptomatology searched while a standardized interrogation.
  • Clinical digestive exam normal.
  • The person won't be allow to participate simultaneously to another study and there won't be an exclusion period to. participation to a clinical or therapeutic trial at the end of this study.
  • Registered to a French social security.
  • Registered to the national file of persons participating to biomedicals searches without direct individual profit.

Who cannot join

  • Subjet under 18 years and more than 60 years.
  • Counter-argument for MRI : presence of intra-corporeal ferro-magnetic particles, claustrophobia.
  • Existence of a severe condition on general level (cardiac, respiratory, hematological, renal, hepatic, cancerous).
  • Existence of an organic digestive affection (gastritis, gallstones, duodenal ulcer, megacolon, inflammatory colitis).
  • Existence or history malignant gastrointestinal condition.
  • History of abdominal digestive surgery except appendectomy, hysterectomy, cure of inguinal hernia)
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  • Recto-anal or périneal active pathology (haemorrhoid , anal fissure …).
  • Presence of arectal fecal impaction.
  • Patient included in an other clinical or therapeutic trial.
  • Patient treated by a drug sensitive to modify sensitivity and/or digestive motor function.
  • Patient regularly receiving psychotropic drugs (anxiolytics, sedatives, antidepressants, neuroleptics).
  • Patient with a pathology that could modify visceral sensitivity like diabetes or neurodegenerative diseases.
  • Persons concerned by articles L1121-5 to L1121-8 of CSP.

Trial locations and contacts

1 site in 1 country.

Bruno Bonaz, Professor contact

04.76.76.55.97

BBonaz@chu-grenoble.fr

Amandine Rubio, Medical doctor contact

04.76.76.59.11

arubio@chu-grenoble.fr

France1 site, 1 recruiting
  • UniversityHospitalGrenoble

    La Tronche, 38700

    Bruno Bonaz, Professor, 04.76.76.55.97, BBonaz@chu-grenoble.fr

    Amandine Rubio, Medical doctor, 04.76.76.59.11, arubio@chu-grenoble.fr

    Recruiting

Other trials in France

About this study

Official title: Anticipation Effect on Painful Phenomenons Linked to Rectal Distension for Patients With a Crohn's Disease in Remission: Functional MRI Study

Crohn's disease goes along with an alteration of the quality of life, even in remission and has a negative impact on stress management linked to the pain and the health. Conversely, stress and psychological variables play a significant role in the pathogenesis of this disease. These interrelations reflects the link between the brain and the digestive tract, called brain-gut axis. The autonomic nervous system (ANS) is the neurological interface, relaying in a bidirectional way, informations between the digestive tract and the central nervous system (CNS).

Visceral information can thus modulate the functionnement of CNS's areas involved in pain management but also in the management of emotional and cognitive behaviours. Yet, numerous work demonstrate the existence of a dysfunction of the ANS during Crohn's disease, with a dysautonomia of the sympatho-vagal balance.

Read more

Human brain respond by advance before and during the application of a painful stimulus that enable the organism to regulate its nociceptive system in order to handle the aversive stimulus incoming, via the activation of brin areas managing the pain, or the raise of pain awareness.

The uncertain and not predictable nature of a painful crisis and/or an inflammatory relapse in a chronic disease like Crohn's disease can be the origin of an anticipating apprehension and anxiety, that could influence visceral perception (increasing it). Nevertheless, only few studies exists about the differential role of certain or uncertain anticipation of the pain, despite the fact that they are associated to different emotional, cognitive and behavioral responses, and the effect of anticipation on painful visceral perception, have not yet been studied for parents in remission of Crohn's disease.

The main goal is to search during certain and uncertain visceral anticipation, induced by distension of an intra-rectal balloon for persons suffering from Crohn's disease in remission, compared to control subjects, with an MRI functional study

Conditions
Crohn's Disease
Being tested
Psychological tests, Magnetic Resonance Imaging, Heart Rate Variability
Keywords
Crohn's disease, Rectal Distension, Remission, Anticipation, Painful
Medical subject headings
Crohn Disease, Pain

What participants receive

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

  • Psychological testsBehavioural

    Related to affective and cognitive dimensions of pain.

  • Magnetic Resonance ImagingDevice

    Also called MRI

    With a certain or uncertain anticipation phase of distension (warning light) followed or not by a rectal distension at the pain threshold previously determined, and then a retrospective quotation of pain during distension and the fear of pain induced by anticipation. Structural MRI and rest of functional connectivity measure MRI.

    With measure of heart rate variability.

  • Heart Rate VariabilityBehavioural

    Also called HRV

    During MRI session, from the electrocardiographic signal. (measure of variations on R-R interval in milliseconds ms).

Study groups in NCT02874495
Study groupRoleWhat they receive
Healthy volunteers22 persons.
Receives: Behavioral: Psychological tests; Device: Magnetic Resonance Imaging; Behavioral: Heart Rate Variability
Patients with Crohn's disease22 patients.
Receives: Behavioral: Psychological tests; Device: Magnetic Resonance Imaging; Behavioral: Heart Rate Variability

What is being measured

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

  1. Magnetic Resonance Imaging

    Activation of cortical cerebral structures involved in visceral pain and communication paths between them With a certain or uncertain anticipation phase of distension (warning light) followed or not by a rectal distension at the pain threshold previously determined, and then a retrospective quotation of pain during distension and the fear of pain induced by anticipation. Structural MRI and rest of functional connectivity measure MRI.

    With measure of heart rate variability.

    Measured: 30 minutes

  2. Heart Rate Variability

    During MRI session, from the electrocardiographic signal. (measure of variations on R-R interval in milliseconds ms).

    Measured: 30 minutes

  3. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Questionnaire of personality inventory NEO-FFI (Bouvard, 2005)

    Measured: 45 minutes

  4. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Questionnaire of depressive symptomatology CES-D (Center for Epidemiologic Studies-Depression Scale; Radloff, 1977)

    Measured: 45 minutes

  5. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Anxiety inventory (STAI-Y of Spielberger)

    Measured: 45 minutes

  6. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Pain Catastrophizing Scale of Sullivan 1995

    Measured: 45 minutes

  7. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Pain Anxiety Symptoms Scale of Cracken 1992

    Measured: 45 minutes

  8. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Fear of Pain Questionnaire of McNeil andRainwater ; 1998

    Measured: 45 minutes

  9. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Visceral Sensitivity Index of Labus; 2004

    Measured: 45 minutes

  10. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Questionnaire of Mindfulness, Walach 2006

    Measured: 45 minutes

  11. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Questionnaire for uncertainty intolerance (Freeston 1994)

    Measured: 45 minutes

  12. Psychological tests

    Related to affective and cognitive dimensions of pain :

    The Illness Attitude Scales, Dammen 1999

    Measured: 45 minutes

  13. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Childhood Trauma Questionnaire of Bernstein 2003

    Measured: 45 minutes

  14. Psychological tests

    Related to affective and cognitive dimensions of pain :

    Ways of Coping Checklist Revised, adapted in French by Cousson 1996

    Measured: 45 minutes

Timeline

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

  1. First posted22 Aug 2016 (estimated)
  2. Study startJan 2012
  3. Primary completionApr 2017 (estimated)
  4. Study completionApr 2017 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Case only
Time perspective
Prospective
Enrolment
44 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02874495
Sponsor's protocol ID
38RC11.220
Acronym
Douleur IRMf
Status last verified
Aug 2016
First submitted
25 Jul 2016
Last updated
22 Aug 2016
Results posted
No
Data monitoring committee
No

Publications

  • Achard S, Salvador R, Whitcher B, Suckling J, Bullmore E. A resilient, low-frequency, small-world human brain functional network with highly connected association cortical hubs. J Neurosci. 2006 Jan 4;26(1):63-72. doi: 10.1523/JNEUROSCI.3874-05.2006.

    PubMed 16399673
  • Al-Chaer ED, Lawand NB, Westlund KN, Willis WD. Visceral nociceptive input into the ventral posterolateral nucleus of the thalamus: a new function for the dorsal column pathway. J Neurophysiol. 1996 Oct;76(4):2661-74. doi: 10.1152/jn.1996.76.4.2661.

    PubMed 8899636
  • Baciu MV, Bonaz BL, Papillon E, Bost RA, Le Bas JF, Fournet J, Segebarth CM. Central processing of rectal pain: a functional MR imaging study. AJNR Am J Neuroradiol. 1999 Nov-Dec;20(10):1920-4.

    PubMed 10588119
  • Baert F, Moortgat L, Van Assche G, Caenepeel P, Vergauwe P, De Vos M, Stokkers P, Hommes D, Rutgeerts P, Vermeire S, D'Haens G; Belgian Inflammatory Bowel Disease Research Group; North-Holland Gut Club. Mucosal healing predicts sustained clinical remission in patients with early-stage Crohn's disease. Gastroenterology. 2010 Feb;138(2):463-8; quiz e10-1. doi: 10.1053/j.gastro.2009.09.056. Epub 2009 Oct 8.

    PubMed 19818785
  • Benarroch EE. The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc. 1993 Oct;68(10):988-1001. doi: 10.1016/s0025-6196(12)62272-1.

    PubMed 8412366
  • Berman SM, Naliboff BD, Suyenobu B, Labus JS, Stains J, Ohning G, Kilpatrick L, Bueller JA, Ruby K, Jarcho J, Mayer EA. Reduced brainstem inhibition during anticipated pelvic visceral pain correlates with enhanced brain response to the visceral stimulus in women with irritable bowel syndrome. J Neurosci. 2008 Jan 9;28(2):349-59. doi: 10.1523/JNEUROSCI.2500-07.2008.

    PubMed 18184777
  • Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, Stokes J, Handelsman L, Medrano M, Desmond D, Zule W. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003 Feb;27(2):169-90. doi: 10.1016/s0145-2134(02)00541-0.

    PubMed 12615092
  • Best WR, Becktel JM, Singleton JW, Kern F Jr. Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology. 1976 Mar;70(3):439-44.

    PubMed 1248701
  • Biswal BB, Mennes M, Zuo XN, Gohel S, Kelly C, Smith SM, Beckmann CF, Adelstein JS, Buckner RL, Colcombe S, Dogonowski AM, Ernst M, Fair D, Hampson M, Hoptman MJ, Hyde JS, Kiviniemi VJ, Kotter R, Li SJ, Lin CP, Lowe MJ, Mackay C, Madden DJ, Madsen KH, Margulies DS, Mayberg HS, McMahon K, Monk CS, Mostofsky SH, Nagel BJ, Pekar JJ, Peltier SJ, Petersen SE, Riedl V, Rombouts SA, Rypma B, Schlaggar BL, Schmidt S, Seidler RD, Siegle GJ, Sorg C, Teng GJ, Veijola J, Villringer A, Walter M, Wang L, Weng XC, Whitfield-Gabrieli S, Williamson P, Windischberger C, Zang YF, Zhang HY, Castellanos FX, Milham MP. Toward discovery science of human brain function. Proc Natl Acad Sci U S A. 2010 Mar 9;107(10):4734-9. doi: 10.1073/pnas.0911855107. Epub 2010 Feb 22.

    PubMed 20176931
  • Bitton A, Dobkin PL, Edwardes MD, Sewitch MJ, Meddings JB, Rawal S, Cohen A, Vermeire S, Dufresne L, Franchimont D, Wild GE. Predicting relapse in Crohn's disease: a biopsychosocial model. Gut. 2008 Oct;57(10):1386-92. doi: 10.1136/gut.2007.134817. Epub 2008 Apr 7.

    PubMed 18390994
  • Blankstein U, Chen J, Diamant NE, Davis KD. Altered brain structure in irritable bowel syndrome: potential contributions of pre-existing and disease-driven factors. Gastroenterology. 2010 May;138(5):1783-9. doi: 10.1053/j.gastro.2009.12.043. Epub 2010 Jan 4.

    PubMed 20045701
  • Bonaz B, Plourde V, Tache Y. Abdominal surgery induces Fos immunoreactivity in the rat brain. J Comp Neurol. 1994 Nov 8;349(2):212-22. doi: 10.1002/cne.903490205.

    PubMed 7860779
  • Bonaz B, Tache Y. Induction of Fos immunoreactivity in the rat brain after cold-restraint induced gastric lesions and fecal excretion. Brain Res. 1994 Jul 25;652(1):56-64. doi: 10.1016/0006-8993(94)90316-6.

    PubMed 7953723
  • Bonaz B, Tache Y. Water-avoidance stress-induced c-fos expression in the rat brain and stimulation of fecal output: role of corticotropin-releasing factor. Brain Res. 1994 Mar 28;641(1):21-8. doi: 10.1016/0006-8993(94)91810-4.

    PubMed 8019847
  • Bonaz B, Riviere PJ, Sinniger V, Pascaud X, Junien JL, Fournet J, Feuerstein C. Fedotozine, a kappa-opioid agonist, prevents spinal and supra-spinal Fos expression induced by a noxious visceral stimulus in the rat. Neurogastroenterol Motil. 2000 Apr;12(2):135-47. doi: 10.1046/j.1365-2982.2000.00188.x.

    PubMed 10771495

Questions about this trial

What is this clinical trial studying?

An observational study of Crohn's Disease, run by University Hospital, Grenoble at 1 site in France.

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 20 inclusion and 13 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: status not confirmed, as of the sponsor's last update on 22 Aug 2016. 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 France. 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. 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?

Results are not available in the source record.

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

Contact Bruno Bonaz, Professor (04.76.76.55.97, BBonaz@chu-grenoble.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Magnetic Resonance Imaging (time frame: 30 minutes). The study lists 14 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 NCT02874495, which also lists 86 linked publications.

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 22 Aug 2016.

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