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HealthyNCT06197529

Is Nociceptive Processing Evoked by Heat Homeostatically Regulated: A Contact-heat Evoked Potentials Study

A study testing Homeostatic Plasticity and Topical alone (Capsaicin 8% Patch) in people with Healthy, run by Aalborg University at 1 site in Denmark.

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

Homeostatic plasticity is a mechanism that stabilizes neuronal activity to prevent excessive nervous system excitability. This mechanism can be investigated in humans by applying two blocks of non-invasive brain stimulation, such as transcranial direct current stimulation (tDCS). Read more about this study

Who is it for?
Ages 18 to 60 yearsHealthy volunteers can take part
Conditions the study is for
Healthy
What is being tested?
Homeostatic Plasticity and Topical alone (Capsaicin 8% Patch)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
18 participants
Where
1 siteDenmark
Study dates
21 Nov 2023to 4 Mar 2024
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 60 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Healthy right-handed men and women aged 18-60 years
  • Speak, read, and understand English or Danish

Who cannot join

  • Pregnant, breastfeeding, or women in childbearing age not using contraceptive methods
  • Regular use of cannabis, opioids or other drugs (except contraceptives)
  • Current or previous neurologic, musculoskeletal, mental, or other illnesses (e.g. brain or spinal cord injuries, degenerative neurological disorders, epilepsy, major depression, cardiovascular disease, chronic lung disease, etc.)
  • Current or previous chronic or recurrent pain condition (other than low back pain in patients recruited for sub-project 6, and this item does not apply to sub-project 8)
  • Current regular use of analgesic medication or other medication which may affect the trial (including paracetamol and NSAIDs) For subproject 8, chronic low back pain patients may take analgesic medication provided the dosage is stable
  • Open wounds, eczema, scars, or tattoos in the area of the heat stimulation (sub-project 1)
Show all 12Show fewer
  • Lack of ability to cooperate
  • Recent history of acute pain particularly in the lower limbs (unless related to low back pain in patients included in sub-project 6 or 8)
  • Abnormally disrupted sleep in 24 hours preceding experiment
  • Any medical or other condition (i.e. musculoskeletal, cardiorespiratory, neurological, etc.)
  • Contraindications to TMS application (history of epilepsy, metal implants in head or jaw, etc.)
  • Unable to answer to the "Transcranial Magnetic Stimulation Adult Safety Screen" or tDCS screening questionnaire (see Bilag_v1_06092021)

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Aalborg University / Center for Neuroplasticity and Pain

    Gistrup, 9260

Other trials in Denmark

About this study

Homeostatic plasticity is a mechanism that stabilizes neuronal activity to prevent excessive nervous system excitability. This mechanism can be investigated in humans by applying two blocks of non-invasive brain stimulation, such as transcranial direct current stimulation (tDCS).

In healthy subjects, homeostatic plasticity induction over the primary motor cortex increases the amplitude of motor-evoked potentials after the first block of excitatory tDCS, which then decreases after the second block of excitatory tDCS. However, this mechanism is impaired in chronic and experimental pain, demonstrated by an increase in excitability instead of a reversal.

Read more

The role of homeostatic plasticity mechanisms in pain is yet to be unraveled, but homeostatic plasticity may hold an important role in pain development or persistence.

Thus, the aim of this study is to investigate if the cortical nociceptive response reflected by contact heat stimulation (CHEPs) is regulated by homeostatic mechanisms. For this, homeostatic plasticity will be induced in both the primary motor (M1) and sensory cortices (S1). The first research question will explore if the contact heat evoked potentials are homeostatically regulated and if this regulation is occurring locally or globally in the cortex. Additionally, it will be investigated if and how capsaicin-induced nociception interacts and effects the homeostatic response as reflected by CHEPs.

Read the detailed description

Randomized, cross-over study of four sessions

Conditions
Healthy
Being tested
Homeostatic Plasticity, Topical alone (Capsaicin 8% Patch), Placebo Patch, Homeostatic Plasticity (Sham)
Keywords
Homeostatic Plasticity, Capsaicin, Transcranial Direct Current Stimulation

What participants receive

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

  • Homeostatic PlasticityOther

    Anodal tDCS S1/M1

  • Topical alone (Capsaicin 8% Patch)Drug

    Also called Qutenza Capsaicin (8%)

    4x4 patch

  • Placebo PatchOther

    4x4 patch

  • Homeostatic Plasticity (Sham)Other

    sham Homeostatic Plasticity protocol over S1

Study groups in NCT06197529
Study groupRoleWhat they receive
S1 Homeostatic Plasticity-PainExperimentalAnodal tDCS CP3 1mA FP2 -1mA 4x4 patch on the dorsum of the hand
Receives: Other: Homeostatic Plasticity; Drug: Topical alone (Capsaicin 8% Patch)
S1 Homeostatic Plasticity-NoPainPlacebo comparatorAnodal tDCS C3 1mA FP2 -1mA 4x4 patch on the dorsum of the hand
Receives: Other: Homeostatic Plasticity; Other: Placebo Patch
S1 Homeostatic Plasticity-ShamSham comparatorSham tDCS C3 FP2 4x4 patch on the dorsum of the hand
Receives: Other: Placebo Patch; Other: Homeostatic Plasticity (Sham)
M1 Homeostatic PlasticityActive comparatorAnodal tDCS C3 1mA FP2 -1mA 4x4 patch on the dorsum of the hand
Receives: Other: Homeostatic Plasticity; Other: Placebo Patch

What is being measured

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

  1. Contact Heat Evoked Potentials

    Baseline (Evoked Potentials after stimulus onset from electroencephalographic channels)

    Measured: Pre-patch application

  2. Contact Heat Evoked Potentials

    Post-Patch (Evoked Potentials after stimulus onset from electroencephalographic channels)

    Measured: 30 minutes after patch application

  3. Contact Heat Evoked Potentials

    Post-Priming (Evoked Potentials after stimulus onset from electroencephalographic channels)

    Measured: During the homeostatic plasticity protocol - 0 minutes after the first block of anodal tDCS

  4. Contact Heat Evoked Potentials

    Post-HP (Evoked Potentials after stimulus onset from electroencephalographic channels)

    Measured: 0 minutes after homeostatic plasticity induction

  5. Contact Heat Evoked Potentials

    Post-HP+10 minutes (Evoked Potentials after stimulus onset from electroencephalographic channels)

    Measured: 10 minutes after the homeostatic plasticity protocol

Secondary outcomes (16)
  1. Pain Intensity After Stimulation Blocks (0-10)

    Pain intensity measured using an 11-point numeric rating scale where 0= no pain and 10 = worst imaginable pain

    Measured: 0 minutes after the first block of CHEP stimulation

  2. Pain Intensity After Stimulation Blocks (0-10)

    Pain intensity measured using an 11-point numeric rating scale where 0= no pain and 10 = worst imaginable pain

    Measured: 0 minutes after the second block of CHEP stimulation

  3. Pain Intensity After Stimulation Blocks

    Pain intensity measured using an 11-point numeric rating scale where 0= no pain and 10 = worst imaginable pain

    Measured: 0 minutes after the third block of CHEP stimulation

  4. Pain Intensity After Stimulation Blocks

    Pain intensity measured using an 11-point numeric rating scale where 0= no pain and 10 = worst imaginable pain

    Measured: 0 minutes after the fourth block of CHEP stimulation

  5. Pain Intensity After Stimulation Blocks

    Pain intensity measured using an 11-point numeric rating scale where 0= no pain and 10 = worst imaginable pain

    Measured: 0 minutes after the fifth block of CHEP stimulation

  6. Presence of Allodynia After Stimulation Blocks

    Measured with a calibrated brush for the study of dynamic mechanical allodynia (Brush-05®, Somedic SenseLab AB, Sösdala, Sweden)

    Measured: 0 minutes after the first block of CHEP stimulation

  7. Presence of Allodynia After Stimulation Blocks

    Measured with a calibrated brush for the study of dynamic mechanical allodynia (Brush-05®, Somedic SenseLab AB, Sösdala, Sweden)

    Measured: 0 minutes after the second block of CHEP stimulation

  8. Presence of Allodynia After Stimulation Blocks

    Measured with a calibrated brush for the study of dynamic mechanical allodynia (Brush-05®, Somedic SenseLab AB, Sösdala, Sweden)

    Measured: 0 minutes after the third block of CHEP stimulation

  9. Presence of Allodynia After Stimulation Blocks

    Measured with a calibrated brush for the study of dynamic mechanical allodynia (Brush-05®, Somedic SenseLab AB, Sösdala, Sweden)

    Measured: 0 minutes after the fourth block of CHEP stimulation

  10. Presence of Allodynia After Stimulation Blocks

    Measured with a calibrated brush for the study of dynamic mechanical allodynia (Brush-05®, Somedic SenseLab AB, Sösdala, Sweden)

    Measured: 0 minutes after the fifth block of CHEP stimulation

  11. Pittsburg Sleeping Quality Index

    The global PSQI score ranges from 0 to 21, calculated by adding seven component scores. A global score above 5 (PSQI > 5) indicates relevant sleep disturbances or poor sleep quality (Buysse et al., 1989).

    Measured: Pre-intervention and pre-patch application

  12. BECKS Depression Inventory

    The questionnaire includes 21 items which are rated on a 4-point scale (0 to 3). The total score is calculated by adding all items. Total score values from 0-13 indicate "normal ups and downs", and scores between 14-19, 20-28, and 29-63, are interpreted as mild, moderate, and severe symptoms (Beck et al., 1996; Goldstein et al., 2013; Wang and Gorenstein, 2013).

    Measured: Pre-intervention and pre-patch application

  13. Positive and Negative Affective Schedule - Short Form

    Scores can range from 10 - 50, with higher scores representing higher levels of positive/negative affect.

    Measured: Pre-intervention and pre-patch application

  14. State-Trait Anxiety Inventory

    A 40-item questionnaire that assesses state and trait anxiety with 20 items each (Skapinakis, 2014; Spielberger et al., 1983). Each subscale (S-Anxiety and T-Anxiety) uses a 4-point Linkert scale ranging from 1 ("not at all" for S- or "almost never" for T-Anxiety) to 4 ("very much so" for S- and "almost always" for T-Anxiety). A higher scole indicates more severe anxiety with a range from 20-80.

    Measured: Pre-intervention and pre-patch application

  15. Pain Catastrophizing Scale

    This questionnaire assesses 13 items describing different thoughts and feelings which may be associated with pain. They are rated on a 5-point scale (0-5) indicating the degree to which these thoughts and feelings are present when having pain. The total score is 0-52, with a higher score indicating a higher pain catastrophizing. (Sullivan M J L, Bishop S, Pivik J. 1995)

    Measured: Pre-intervention and pre-patch application

  16. Pain intensity (Induced by Capsaicin)

    Pain intensity measured using an 11-point numeric rating scale where 0= no pain and 10 = worst imaginable pain

    Measured: Throughout the experimental session, every 5 minutes and up to 55 minutes after patch application

Timeline

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

  1. First posted9 Jan 2024
  2. Study start21 Nov 2023
  3. Primary completion4 Mar 2024
  4. Study completion4 Mar 2024

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
Basic science
Allocation
Randomised
Intervention model
Crossover
Masking
Single blind
Who is masked
Participant
Enrolment
18 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06197529
Sponsor's protocol ID
CHEPS-DMZ-CNAP
Status last verified
May 2024
First submitted
22 Nov 2023
Last updated
16 May 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The individual participant data will not be available online, but the data collected can be shared upon reasonable request.

Publications

  • Wittkopf PG, Larsen DB, Gregoret L, Graven-Nielsen T. Prolonged corticomotor homeostatic plasticity - Effects of different protocols and their reliability. Brain Stimul. 2021 Mar-Apr;14(2):327-329. doi: 10.1016/j.brs.2021.01.017. Epub 2021 Jan 24. No abstract available.

    PubMed 33503491
  • Wittkopf PG, Larsen DB, Graven-Nielsen T. Protocols for inducing homeostatic plasticity reflected in the corticospinal excitability in healthy human participants: A systematic review and meta-analysis. Eur J Neurosci. 2021 Aug;54(4):5444-5461. doi: 10.1111/ejn.15389. Epub 2021 Jul 30.

    PubMed 34251703
  • Wittkopf PG, Boye Larsen D, Gregoret L, Graven-Nielsen T. Disrupted Cortical Homeostatic Plasticity Due to Prolonged Capsaicin-induced Pain. Neuroscience. 2023 Nov 21;533:1-9. doi: 10.1016/j.neuroscience.2023.09.011. Epub 2023 Sep 27.

    PubMed 37774909
  • Thapa T, Graven-Nielsen T, Schabrun SM. Aberrant plasticity in musculoskeletal pain: a failure of homeostatic control? Exp Brain Res. 2021 Apr;239(4):1317-1326. doi: 10.1007/s00221-021-06062-3. Epub 2021 Feb 26.

    PubMed 33635391
  • Thapa T, Graven-Nielsen T, Chipchase LS, Schabrun SM. Disruption of cortical synaptic homeostasis in individuals with chronic low back pain. Clin Neurophysiol. 2018 May;129(5):1090-1096. doi: 10.1016/j.clinph.2018.01.060. Epub 2018 Feb 9.

    PubMed 29472134
  • Lejeune N, Petrossova E, Frahm KS, Mouraux A. High-speed heating of the skin using a contact thermode elicits brain responses comparable to CO2 laser-evoked potentials. Clin Neurophysiol. 2023 Feb;146:1-9. doi: 10.1016/j.clinph.2022.11.008. Epub 2022 Nov 24.

    PubMed 36473333
  • Lenoir C, Algoet M, Mouraux A. Deep continuous theta burst stimulation of the operculo-insular cortex selectively affects Adelta-fibre heat pain. J Physiol. 2018 Oct;596(19):4767-4787. doi: 10.1113/JP276359. Epub 2018 Sep 4.

    PubMed 30085357

Questions about this trial

What is this clinical trial studying?

A study testing Homeostatic Plasticity and Topical alone (Capsaicin 8% Patch) in people with Healthy, run by Aalborg University at 1 site in Denmark.

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 2 inclusion and 12 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 16 May 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 Denmark. 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?

Contact Heat Evoked Potentials (time frame: Pre-patch application). The study lists 5 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 NCT06197529, which also lists 7 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 16 May 2024.

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