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Vasculitic NeuropathyNCT04720196

Analgesic Effect of rTMS in Vasculitic Neuropathy

A study testing Active repetitive transcranial magnetic stimulation in people with Vasculitic Neuropathy, run by Jagiellonian University at 1 site in Poland.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Vasculitic neuropathy (VN) results from inflammation and destruction of the walls of predominantly small vessels with subsequent ischemic damage of peripheral nerves. VN is painful in vast majority of patients and the pain is intractable with pharmacotherapy in about 40% of cases. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Vasculitic Neuropathy
What is being tested?
Active repetitive transcranial magnetic stimulation
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
3 participants
Where
1 sitePoland
Study dates
25 Jan 2021to 21 Sep 2023
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis of vasculitic neuropathy
  • Neuropathic pain of constant severity since not less than a month and requiring use of analgesics more than once a week
  • Score of 30 milimeter or more on the 100 milimeter visual analog scale of pain intensity at inclusion

Who cannot join

  • Severe depression
  • Personality disorders and other psychiatric conditions, which could disturb the participation in the study
  • Cognitive deficits, which could disturb the participation in the study
  • Contraindications for rTMS as listed by the Guidelines of the International Federation of Clinical Neurophysiology (Rossi et al. 2009) i.e. seizure in the past, epilepsy, presence of magnetic material in the reach of magnetic field, pregnancy, likelihood to get pregnant, intracranial electrodes, cardiac pacemaker or intracardiac lines, frequent syncopes

Trial locations and contacts

1 site in 1 country.

Poland1 site
  • Jagiellonian University Medical College, Department of Neurology

    Krakow, 31503

Other trials in Poland

About this study

Official title: Analgesic Effect of Repetitive Transcranial Magnetic Stimulation in Painful Vasculitic Neuropathy

Vasculitic neuropathy (VN) results from inflammation and destruction of the walls of predominantly small vessels with subsequent ischemic damage of peripheral nerves. VN is painful in vast majority of patients and the pain is intractable with pharmacotherapy in about 40% of cases. Repetitive Transcranial Magnetic Stimulation (rTMS) is a noninvasive method of modulation of brain plasticity and is regarded as one of alternative methods to alleviate pain associated with various kind of neuropathies. The purpose of this study is to compare the effectiveness of analgesic effect of rTMS in vasculitic neuropathy with sham stimulation.

Read the detailed description

Vasculitic neuropathies (VN) are a group of disorders resulting from inflammation of predominantly small vessels with destruction of their walls and subsequent ischemic damage of peripheral nerves. Neural damage may or may not coexist with the damage of other organs. Examples of conditions associated with VN include diabetes, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis (Churg-Strauss), granulomatosis with polyangiitis (Wegener's), rheumatoid arthritis, systemic lupus erythematosus and others. VN is painful in about 80% of patients of whom 40% suffer from the pain intractable with pharmacological therapy. Repetitive Transcranial Magnetic Stimulation (rTMS) is a noninvasive method of modulation of brain plasticity. In this method, series of magnetic stimuli are delivered to the cerebral cortex, where they turn to electric current and depolarize repetitively the targeted neurons. If the stimulation is repeated during subsequent days it is capable to modify the activity of targeted cortical area for weeks or even months and by this way to achieve therapeutic effect. rTMS is widely regarded as one of alternative methods to alleviate pain associated with various kind of neuropathies. The purpose of this study is to compare the effectiveness of analgesic effect of rTMS in vasculitic neuropathy with sham stimulation.

Being tested
Active repetitive transcranial magnetic stimulation, Sham repetitive transcranial magnetic stimulation
Keywords
vasculitis, neuropathy, pain, transcranial magnetic stimulation, analgesic effect
Medical subject headings
Vasculitis, Pain

What participants receive

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

  • Active repetitive transcranial magnetic stimulationDevice

    High frequency rTMS over the primary motor area to induce the long term potentiation of primary motor areas for the muscles of upper extremity.

  • Sham repetitive transcranial magnetic stimulationDevice

    Sham stimulation to mimic the high frequency rTMS over the primary motor area.

Study groups in NCT04720196
Study groupRoleWhat they receive
Active repetitive transcranial magnetic stimulationExperimental10 hertz (Hz) rTMS will be administered over the primary motor area. Therapy will include 5 daily sessions (on consecutive week days). In every sessions 1500 magnetic pulses of 90% of the resting motor threshold intensity will be elicited.
Receives: Device: Active repetitive transcranial magnetic stimulation
Sham repetitive transcranial magnetic stimulationSham comparatorSham stimulation will mimic the active one except that the stimulating coil will be held perpendicularly to the scalp, which assures similar impression as the active stimulation but prevents that significant magnetic field will reach brain tissue.
Receives: Device: Sham repetitive transcranial magnetic stimulation

What is being measured

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

  1. Numeric Pain Severity Scale after rTMS

    Total score 10, with higher scores representing more severe pain. Change from baseline score in the Numeric Pain Severity Scale to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  2. Numeric Pain Severity Scale First Follow Up

    Total score 10, with higher scores representing more severe pain. Change from baseline score in the Numeric Pain Severity Scale to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  3. Numeric Pain Severity Scale Second Follow Up

    Total score 10, with higher scores representing more severe pain. Change from baseline score in the Numeric Pain Severity Scale to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  4. Visual Analog Scale of Pain Severity

    An analog scale of the length of 100 milimeter. Total score of 100, with higher scores representing more severe pain. Change through the study.

    Measured: Through study completion, an average of 10 weeks

Secondary outcomes (33)
  1. Hospital Anxiety and Depression Scale after rTMS

    Total score 64, with higher scores representing more severe depression. Change from baseline score in the Hospital Anxiety and Depression Scale to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  2. Hospital Anxiety and Depression Scale First Follow Up

    Total score 64, with higher scores representing more severe depression. Change from baseline score in the Hospital Anxiety and Depression Scale to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  3. Hospital Anxiety and Depression Scale Second Follow Up

    Total score 64, with higher scores representing more severe depression. Change from baseline score in the Hospital Anxiety and Depression Scale to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  4. 36-Item Short Form Health Survey after rTMS

    Total score, range 0 to 800, with lower values representing a worse outcome. Change from baseline score in the 36-Item Short Form Health Survey to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  5. 36-Item Short Form Health Survey First Follow Up

    Total score, range 0 to 800, with lower values representing a worse outcome. Change from baseline score in the 36-Item Short Form Health Survey to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  6. 36-Item Short Form Health Survey Second Follow Up

    Total score, range 0 to 800, with lower values representing a worse outcome. Change from baseline score in the 36-Item Short Form Health Survey to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  7. Quality of Life in Neurological Disorders (Neuro-QoL) Upper Extremity Function after rTMS

    Total score, range 0 to 100, with lower values representing a worse outcome. Change from baseline score in Neuro-Qol Upper Extremity Function to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  8. Quality of Life in Neurological Disorders (Neuro-QoL) Upper Extremity Function First Follow Up

    Total score, range 0 to 100, with lower values representing a worse outcome. Change from baseline score in Neuro-Qol Upper Extremity Function to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  9. Quality of Life in Neurological Disorders (Neuro-QoL) Upper Extremity Function Second Follow Up

    Total score, range 0 to 100, with lower values representing a worse outcome. Change from baseline score in Neuro-Qol Upper Extremity Function to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  10. Assessment of pain threshold to electric stimuli after rTMS

    Electrocutaneus stimulation with gradually increasing intensity from 0mA until a patient reports that the sensation has become painful. Change from baseline pain threshold to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  11. Assessment of sensory threshold to electric stimuli after rTMS

    Electrocutaneus stimulation with gradually increasing intensity from 0mA until a patient reports the first nonpainful tactile sensation. Change from baseline sensory threshold to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  12. Assessment of pain threshold to electric stimuli First Follow Up

    Electrocutaneus stimulation with gradually increasing intensity from 0mA until a patient reports that the sensation has become painful. Change from baseline pain threshold to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  13. Assessment of sensory threshold to electric stimuli First Follow Up

    Electrocutaneus stimulation with gradually increasing intensity from 0mA until a patient reports the first nonpainful tactile sensation. Change from baseline sensory threshold to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  14. Assessment of pain threshold to electric stimuli Second Follow Up

    Electrocutaneus stimulation with gradually increasing intensity from 0mA until a patient reports that the sensation has become painful. Change from baseline pain threshold to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  15. Assessment of sensory threshold to electric stimuli Second Follow Up

    Electrocutaneus stimulation with gradually increasing intensity from 0mA until a patient reports the first nonpainful tactile sensation. Change from baseline sensory threshold to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  16. Assessment of cold sensation threshold to cold stimuli after rTMS

    Stimulation with cold temperature stimuli, gradually colder, starting from from 32 degree Celcius until patient will report that he feels cold. Change from baseline cold sensation threshold to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  17. Assessment of pain threshold to cold temeprature stimuli after rTMS

    Stimulation with cold temperature stimuli, gradually colder, starting from 32 degree Celcius until patient starts to perceive stimuli as painful. Change from baseline pain threshold to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  18. Assessment of cold sensation threshold to cold temeprature stimuli First Follow Up

    Stimulation with cold temperature stimuli, gradually colder, starting from from 32 degree Celcius until patient will report that he feels cold. Change from baseline cold sensation threshold to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  19. Assessment of pain threshold to cold temeprature stimuli First Follow Up

    Stimulation with cold temperature stimuli, gradually colder, starting from 32 degree Celcius until patient starts to perceive stimuli as painful. Change from baseline pain threshold to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  20. Assessment of cold sensation threshold to cold temeprature stimuli Second Follow Up

    Stimulation with cold temperature stimuli, gradually colder, starting from from 32 degree Celcius until patient will report that he feels cold. Change from baseline cold sensation threshold to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  21. Assessment of pain threshold to cold temeprature stimuli Second Follow Up

    Stimulation with cold temperature stimuli, gradually colder, starting from 32 degree Celcius until patient starts to perceive stimuli as painful. Change from baseline pain threshold to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  22. Assessment of warmth sensation threshold to warm temeprature stimuli after rTMS

    Stimulation with warm temperature stimuli, gradually warmer, starting from from 32 degree Celcius until patient will report that he feels warmth. Change from baseline warmth sensation threshold to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  23. Assessment of pain threshold to warm temeprature stimuli after rTMS

    Stimulation with warm temperature stimuli, gradually warmer, starting from 32 degree Celcius until patient starts to perceive stimuli as painful. Change from baseline pain threshold to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  24. Assessment of warmth sensation threshold to warm temeprature stimuli First Follow Up

    Stimulation with warm temperature stimuli, gradually warmer, starting from from 32 degree Celcius until patient will report that he feels warmth. Change from baseline warmth sensation threshold to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  25. Assessment of pain threshold to warm temeprature stimuli First Follow Up

    Stimulation with warm temperature stimuli, gradually warmer, starting from 32 degree Celcius until patient starts to perceive stimuli as painful. Change from baseline pain threshold to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  26. Assessment of warmth sensation threshold to warm temeprature stimuli Second Follow Up

    Stimulation with warm temperature stimuli, gradually warmer, starting from from 32 degree Celcius until patient will report that he feels warmth. Change from baseline warmth sensation threshold to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  27. Assessment of pain threshold to warm temeprature stimuli Second Follow Up

    Stimulation with warm temperature stimuli, gradually warmer, starting from 32 degree Celcius until patient starts to perceive stimuli as painful. Change from baseline pain threshold to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  28. Bilateral Dynamometric Assessment of the strength of the index finger flexion after rTMS

    Change from baseline strength of the index finger flexion to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  29. Bilateral Dynamometric Assessment of the strength of the foot extension after rTMS

    Change from baseline strength of the foot extension to the measurement taken after finishing rTMS.

    Measured: Before rTMS, immediately after (on same day) finishing rTMS.

  30. Bilateral Dynamometric Assessment of the strength of the index finger flexion First Follow Up

    Change from baseline strength of the index finger flexion to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  31. Bilateral Dynamometric Assessment of the strength of the foot extension flexion First Follow Up

    Change from baseline strength of the foot extension to the measurement taken two weeks after finishing rTMS.

    Measured: Before rTMS, two weeks after finishing rTMS

  32. Bilateral Dynamometric Assessment of the strength of the index finger flexion Second Follow Up

    Change from baseline strength of the index finger flexion to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

  33. Bilateral Dynamometric Assessment of the strength of the foot extension Second Follow Up

    Change from baseline strength of the index foot extension to the measurement taken four weeks after finishing rTMS.

    Measured: Before rTMS, four weeks after finishing rTMS

Timeline

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

  1. First posted22 Jan 2021
  2. Study start25 Jan 2021
  3. Primary completion20 Sep 2023
  4. Study completion21 Sep 2023

Why it stopped: Insufficient recruitment

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
Crossover
Model description
Patients will be randomly assigned to active and then sham stimulation or to sham and then active stimulation.
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
3 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04720196
Sponsor's protocol ID
JagiellonianU63
Status last verified
Sep 2023
First submitted
16 Jan 2021
Last updated
2 Oct 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: After completing the study, the age and gender of participants as well as the scores and results of all outcome measurements made at baseline, after rTMS, at the first and at the second follow up will be made available to other researchers on request.

Publications

  • Rossi S, Hallett M, Rossini PM, Pascual-Leone A; Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009 Dec;120(12):2008-2039. doi: 10.1016/j.clinph.2009.08.016. Epub 2009 Oct 14.

    PubMed 19833552

Questions about this trial

What is this clinical trial studying?

A study testing Active repetitive transcranial magnetic stimulation in people with Vasculitic Neuropathy, run by Jagiellonian University at 1 site in Poland.

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 3 inclusion and 4 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: stopped early, as of the sponsor's last update on 2 Oct 2023. 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 Poland. 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 was stopped early (reason given: Insufficient recruitment). Results are not available in the source record.

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?

Numeric Pain Severity Scale after rTMS (time frame: Before rTMS, immediately after (on same day) finishing rTMS.). The study lists 4 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 NCT04720196, 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 2 Oct 2023.

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