Trial Outcomes & Findings for Cranial Electrotherapy Stimulation in Burned Patients (NCT NCT00723008)

NCT ID: NCT00723008

Last Updated: 2013-03-22

Results Overview

Subjects were asked to complete questionnaire three times during the course of study. Questions addressed symptoms associated with Post Traumatic Stress Disorder(PTSD). Scores can range from 17 to 85. A score \>31 was used to identify symptomatic subjects and was therefore required at baseline for study enrollment.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

20 participants

Primary outcome timeframe

Baseline, Week 4, Week 8

Results posted on

2013-03-22

Participant Flow

Military service members who received outpatient rehabilitation through the US Army Institute of Surgical research (USAISR) were enrolled September 12, 2007-January 9,2009.

Participant milestones

Participant milestones
Measure
A: Active/Unblinded
Upon randomization, a double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
B: Sham/Unblinded
Upon randomization, a double blinded Alpha Stim 100 device preset to no stimulation (0/6)will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
Enrollment
STARTED
11
9
Enrollment
COMPLETED
10
9
Enrollment
NOT COMPLETED
1
0
4-Week Double Blinded
STARTED
10
9
4-Week Double Blinded
COMPLETED
5
4
4-Week Double Blinded
NOT COMPLETED
5
5
4-Week Unblinded Treatment
STARTED
5
4
4-Week Unblinded Treatment
COMPLETED
4
3
4-Week Unblinded Treatment
NOT COMPLETED
1
1

Reasons for withdrawal

Reasons for withdrawal
Measure
A: Active/Unblinded
Upon randomization, a double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
B: Sham/Unblinded
Upon randomization, a double blinded Alpha Stim 100 device preset to no stimulation (0/6)will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
Enrollment
Lost to Follow-up
1
0
4-Week Double Blinded
Lack of Efficacy
0
1
4-Week Double Blinded
Withdrawal by Subject
1
1
4-Week Double Blinded
Lost to Follow-up
4
3
4-Week Unblinded Treatment
Adverse Event
1
0
4-Week Unblinded Treatment
Lost to Follow-up
0
1

Baseline Characteristics

Cranial Electrotherapy Stimulation in Burned Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
A: Active/Unblinded
n=11 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
B: Sham/Unblinded
n=9 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to no stimulation (0/6)will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
Total
n=20 Participants
Total of all reporting groups
Age Continuous
26.3 years
STANDARD_DEVIATION 4.9 • n=5 Participants
27.3 years
STANDARD_DEVIATION 4.9 • n=7 Participants
26.8 years
STANDARD_DEVIATION 4.8 • n=5 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Sex: Female, Male
Male
11 Participants
n=5 Participants
9 Participants
n=7 Participants
20 Participants
n=5 Participants
Race/Ethnicity, Customized
Caucasian
5 participants
n=5 Participants
8 participants
n=7 Participants
13 participants
n=5 Participants
Race/Ethnicity, Customized
African American
3 participants
n=5 Participants
0 participants
n=7 Participants
3 participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic
3 participants
n=5 Participants
0 participants
n=7 Participants
3 participants
n=5 Participants
Race/Ethnicity, Customized
Other, not specified
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline, Week 4, Week 8

Population: All active subjects

Subjects were asked to complete questionnaire three times during the course of study. Questions addressed symptoms associated with Post Traumatic Stress Disorder(PTSD). Scores can range from 17 to 85. A score \>31 was used to identify symptomatic subjects and was therefore required at baseline for study enrollment.

Outcome measures

Outcome measures
Measure
A: Active/Unblinded
n=11 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
B: Sham/Unblinded
n=9 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to no stimulation (0/6)will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
Group B: BEFORE Sham or CES Treatment
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Group B: AFTER Sham or CES Treatment
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Mean Post-Traumatic Stress Questionnaire-Military (PCL-M) Score
Baseline
53.8 Score
Standard Deviation 16.4
56.7 Score
Standard Deviation 9.6
Mean Post-Traumatic Stress Questionnaire-Military (PCL-M) Score
Week 4
48.8 Score
Standard Deviation 15.3
50.4 Score
Standard Deviation 17.1
Mean Post-Traumatic Stress Questionnaire-Military (PCL-M) Score
Week 8
55.5 Score
Standard Deviation 14.8
44.7 Score
Standard Deviation 2.1

PRIMARY outcome

Timeframe: Baseline, 4 Weeks, 8 Weeks

Population: One A:Active/Unblinded subject was removed from analysis due to a 31-point outlying score. All other subjects who remained in study at each given period were analyzed. Therefore, the number of subjects examined decreased at each interval.

This 20-item questionnaire measures depressive symptoms. Scores can range from 0-60, with scores greater than 16 indicating need for further evaluation due to possible Major Depression.

Outcome measures

Outcome measures
Measure
A: Active/Unblinded
n=10 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
B: Sham/Unblinded
n=9 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to no stimulation (0/6)will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
Group B: BEFORE Sham or CES Treatment
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Group B: AFTER Sham or CES Treatment
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Mean Center for Epidemiological Studies-Depression Scale (CES-D) Score
Baseline
28.8 Score
Standard Deviation 8.9
30.6 Score
Standard Deviation 9.9
Mean Center for Epidemiological Studies-Depression Scale (CES-D) Score
Week 4
27.5 Score
Standard Deviation 8.2
24.5 Score
Standard Deviation 13.0
Mean Center for Epidemiological Studies-Depression Scale (CES-D) Score
Week 8
36.3 Score
Standard Deviation 4.5
21.7 Score
Standard Deviation 9.8

PRIMARY outcome

Timeframe: Baseline, Week 4, Week 8

Population: One A:Active/Unblinded subject was removed from analysis due to a 39-point outlying score. All other subjects who remained in study at each given period were analyzed. Therefore, the number of subjects examined decreased at each interval.

BPOMS is a tool used to qualitatively measure anxiety. Subjects were asked to evaluate 30 feelings that they may have had over the past week. Stress-associated feelings are scored on a 5-point Likert scale from 0 (not at all)to 4 (extremely). Six of the feelings listed on the questionnaire are not associated with anxiety and therefore are not scored. Total scores range from 0-96, with higher scores indicating greater tension and anxiety.

Outcome measures

Outcome measures
Measure
A: Active/Unblinded
n=10 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
B: Sham/Unblinded
n=9 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to no stimulation (0/6)will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
Group B: BEFORE Sham or CES Treatment
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Group B: AFTER Sham or CES Treatment
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Mean Brief Profile of Mood States (BPOMS) Score
Baseline
50.2 Brief POMS Score
Standard Deviation 21.7
55.9 Brief POMS Score
Standard Deviation 15.4
Mean Brief Profile of Mood States (BPOMS) Score
Week 4
42.3 Brief POMS Score
Standard Deviation 21.9
50.3 Brief POMS Score
Standard Deviation 10.3
Mean Brief Profile of Mood States (BPOMS) Score
Week 8
51.0 Brief POMS Score
Standard Deviation 11.5
41.0 Brief POMS Score
Standard Deviation 9.9

PRIMARY outcome

Timeframe: Blinded Period, Unblinded Period

Population: All subjects who remained in study at each given period were analyzed. Therefore, the number of subjects examined decreased at each interval.

Subjects were asked to evaluate their pain intensity before and after each daily CES or sham treatment. Responses were scored on a scale ranging from 0 (indicating no pain) to 10 (worst possible pain).

Outcome measures

Outcome measures
Measure
A: Active/Unblinded
n=11 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
B: Sham/Unblinded
n=11 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to no stimulation (0/6)will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
Group B: BEFORE Sham or CES Treatment
n=9 Participants
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Group B: AFTER Sham or CES Treatment
n=9 Participants
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Mean Visual Analogue Scale of Pain (VAS-P) Before and After Cranial Electrotherapy Stimulation (CES).
Blinded Period: CES or Sham
3.7 VAS-P Score
Standard Deviation 1.7
3.3 VAS-P Score
Standard Deviation 1.9
3.9 VAS-P Score
Standard Deviation 1.5
4.2 VAS-P Score
Standard Deviation 1.7
Mean Visual Analogue Scale of Pain (VAS-P) Before and After Cranial Electrotherapy Stimulation (CES).
Unblinded: Open Label Sensate Period
2.9 VAS-P Score
Standard Deviation 2.1
2.3 VAS-P Score
Standard Deviation 1.7
3.3 VAS-P Score
Standard Deviation 1.4
2.8 VAS-P Score
Standard Deviation 1.9

PRIMARY outcome

Timeframe: Blinded Period, Unblinded Period

Population: All subjects who remained in study at each given period were analyzed. Therefore, the number of subjects examined decreased at each interval

Subjects were asked to evaluate their anxiety level before and after each daily CES treatment. Responses were scored on a scale ranging from 0 (indicating no anxiety) to 10 (worst possible).

Outcome measures

Outcome measures
Measure
A: Active/Unblinded
n=11 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
B: Sham/Unblinded
n=11 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to no stimulation (0/6)will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
Group B: BEFORE Sham or CES Treatment
n=9 Participants
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Group B: AFTER Sham or CES Treatment
n=9 Participants
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Mean Visual Analogue Scale of Anxiety (VAS-A) Before and After Cranial Electrotherapy Stimulation (CES).
Blinded Period
3.6 VAS-A Score
Standard Deviation 2.1
3.2 VAS-A Score
Standard Deviation 2.2
3.3 VAS-A Score
Standard Deviation 1.7
3.3 VAS-A Score
Standard Deviation 1.7
Mean Visual Analogue Scale of Anxiety (VAS-A) Before and After Cranial Electrotherapy Stimulation (CES).
Unblinded, Open Label Sensate Period
2.6 VAS-A Score
Standard Deviation 1.9
2.1 VAS-A Score
Standard Deviation 1.7
2.8 VAS-A Score
Standard Deviation 1.1
2.3 VAS-A Score
Standard Deviation 1.5

PRIMARY outcome

Timeframe: Baseline, Week 4, Week 8

Population: All subjects who remained in study at each given period were analyzed. Therefore, the number of subjects examined decreased at each interval.

The GSDS is a questionnaire used to qualitatively evaluate sleep. This 21-question tool evaluates each aspect of sleep and restfulness on a 0-7 score, indicating the number of days per week that each problem may be present. Total scores range from 0-147, with higher scores indicating more profound disturbances in sleep.

Outcome measures

Outcome measures
Measure
A: Active/Unblinded
n=11 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
B: Sham/Unblinded
n=9 Participants
Upon randomization, a double blinded Alpha Stim 100 device preset to no stimulation (0/6)will be applied to the earlobes of the subject for one hour per day for 5 days per week for 4 weeks; after the blinded period is completed the patient will wear a different Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6). Report of pain, anxiety will be assessed before and after each daily session during the 8 week period. Alpha Stim 100 (Cranial Electrotherapy Stimulation) : cranial electrical stimulation 100 microamps
Group B: BEFORE Sham or CES Treatment
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Group B: AFTER Sham or CES Treatment
Subjects receiving 4 weeks of Sham CES treatment followed by 4 weeks of open label sensate treatment
Mean General Sleep Disturbance Scale (GSDS) Score
Baseline
76.3 Score
Standard Deviation 22.7
90.8 Score
Standard Deviation 13.0
Mean General Sleep Disturbance Scale (GSDS) Score
Week 4
80.6 Score
Standard Deviation 16.4
83.3 Score
Standard Deviation 14.8
Mean General Sleep Disturbance Scale (GSDS) Score
Week 8
67.8 Score
Standard Deviation 30.0
56.3 Score
Standard Deviation 14.6

Adverse Events

Group A: Blinded Phase

Serious events: 0 serious events
Other events: 8 other events
Deaths: 0 deaths

Group A: Unblinded Phase

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Group B: Blinded Phase

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Group B: Unblinded Phase

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Group A: Blinded Phase
n=11 participants at risk
Subjects receiving double blinded Alpha Stim 100 device preset to the lowest effective setting (1/6) for one hour daily.
Group A: Unblinded Phase
n=5 participants at risk
Subjects using Alpha Stim device that has not been blinded for one hour per day for 5 days per week for 4 weeks, with settings at the patient's preference (1 to 6/6).
Group B: Blinded Phase
n=9 participants at risk
Subjects receiving sham CES treatment for 1 hour daily for 4 weeks.
Group B: Unblinded Phase
n=4 participants at risk
Subjects Previously receiving sham device, now using active Alpha Stim device with settings at the patient's preference (1 to 6/6), one hour per day for 5 days per week for 4 weeks.
Nervous system disorders
Ear Pain, Tingling
18.2%
2/11 • Number of events 2
20.0%
1/5 • Number of events 1
22.2%
2/9 • Number of events 2
50.0%
2/4 • Number of events 2
Nervous system disorders
Headache
9.1%
1/11 • Number of events 2
0.00%
0/5
0.00%
0/9
0.00%
0/4
Psychiatric disorders
Increased Irritability
9.1%
1/11 • Number of events 1
0.00%
0/5
0.00%
0/9
0.00%
0/4
Nervous system disorders
Increased Injury Site Pain
36.4%
4/11 • Number of events 5
0.00%
0/5
22.2%
2/9 • Number of events 16
25.0%
1/4 • Number of events 19
Nervous system disorders
Lightheadedness
0.00%
0/11
0.00%
0/5
11.1%
1/9 • Number of events 1
0.00%
0/4
Gastrointestinal disorders
Nausea
9.1%
1/11 • Number of events 1
0.00%
0/5
0.00%
0/9
0.00%
0/4
Psychiatric disorders
Night Terrors
9.1%
1/11 • Number of events 1
0.00%
0/5
0.00%
0/9
0.00%
0/4
Musculoskeletal and connective tissue disorders
Stiffness/ soreness
0.00%
0/11
0.00%
0/5
11.1%
1/9 • Number of events 1
0.00%
0/4
Psychiatric disorders
Insomnia
18.2%
2/11 • Number of events 2
0.00%
0/5
0.00%
0/9
0.00%
0/4

Additional Information

LTC. Elizabeth Mann-Salinas, PhD, RN,CCRN,CCNS

U.S. Army Institute of Surgical Research

Phone: 210-916-3527

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place