Improvement the Anti-migraine Treatment Efficacy by Tailoring the Drug to Individual's Pain Modulation Profile

NCT ID: NCT01470339

Last Updated: 2015-09-17

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 200 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-12-31
• Study Completion Date: 2014-07-31

Brief Summary

• To delineate brain mechanisms that subserve endogenous analgesic (EA) in the healthy state.
• To identify alterations in mechanisms supporting EA in chronic pain (migraine) and their therapeutic relevance.

Detailed Description

The proposed research will use psychophysics and multiparametric MRI to (i) delineate the brain mechanisms that subserve and regulate endogenous analgesia (EA)in the healthy state and (ii) to identify alterations in mechanisms supporting EA in chronic pain and their therapeutic relevance. In both healthy subjects and chronic pain patients, EA will be probed using the DNIC (diffuse noxious inhibitory controls) and offset analgesia paradigms. Functional MRI will examine activation of brainstem mechanisms important in EA, while both functional and structural connectivity analyses will assess the regulation of these brainstem mechanisms by cerebral cortical regions involved in attention and affect. One pathological painful condition, migraine, will be examined since it allows changes in EA associated with chronic pain to be investigated between episodes of pain. Finally, EA and EA associated structural and functional parameters will be used to predict the efficacy of one compound, amitriptyline, to treat migraine in individual patients. Taken together, the proposed research will provide substantial insights into basic mechanisms supporting and regulating EA and can provide a foundation for mechanism-based individualized choice of therapy that may benefit all chronic pain patients.

Conditions

Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Blinding Strategy: DOUBLE

Study Groups

placebo

migraine patients to receive placebo treatment

Group Type: PLACEBO_COMPARATOR

duloxetine

Intervention Type: DRUG

duloxetine 60mg once a day for 5 weeks

duloxetine

migraine patients to receive duloxetine

Group Type: ACTIVE_COMPARATOR

duloxetine

Intervention Type: DRUG

duloxetine 60mg once a day for 5 weeks

Interventions

duloxetine

duloxetine 60mg once a day for 5 weeks

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• healthy females
• migaine females
• ages 18-50
• for migraineurs: >4 attacks/month

Exclusion Criteria

• any migraine preventive treatment received during last 3 months or prior treatment with amytriptiline
• other chronic pain conditions
• psychiatric, other neurological diseases, language barrier or cognitive dysfunction
• Patients and controls will be asked to withdraw from any pain-relieving medications for 24 hours before the testing. The tests will be performed interictally atleast 2 days after the last attack.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: Yes

Sponsors

Rambam Health Care Campus

OTHER

Sponsor Role: lead

Responsible Party

d_yarnitsky

Professor, Head on Neurology Department

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

David Yarnitsky, professor

Role: PRINCIPAL_INVESTIGATOR

Rambam Health Care Campus

Locations

MRI center

Haifa, , Israel

Countries

Israel

Other Identifiers

0462-10-RMB.CTIL

Identifier Type: -

Identifier Source: org_study_id