Effectiveness and Reliability of Hypnosis in Stereotaxy

NCT ID: NCT03074422

Last Updated: 2018-10-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-07-01

Study Completion Date

2020-07-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

In certain neurosurgical procedures, the use of a stereotaxic frame is required. It is then possible to set a precise target (depending of the type of the surgery) to be reached by the surgeon. The fixation of the stereotactic frame on the awake patient's head is done under local anesthesia by screwing the frame directly into the skull. This procedure is reported as "painful" to "extremely painful" by patients. The objective of this study is to determine whether the hypnosis is effective in decreasing the pain perceived by the patient during the disposal of the stereotactic frame.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The role of hypnosis (no sedative drug administered) and hypnosedative procedures (hypnosis with the adjunct of a sedative drug) during surgical procedures has been largely discussed during the past 10 years, and those techniques are now widely practiced in the surgical field, for example during thyroidectomies. In neurosurgery specifically, the successful use of hypnosedation during awake neurosurgical procedures has been recently reported, with a positive feedback from the patients, together with good results regarding extent of resection, in the case of brain lesions located in eloquent areas.

Since 1990, many research groups identified the existence of hypnosis-related phenomena and their influence on the pain signal perception. These authors show that there is a modulation of the anterior cingulate area activity together with modified interconnectivity with other critical regions involved in nociception. In this context, the potential of hypnosis in pain modulation and, more extensively, patient management in surgical anesthetics was established.

In various neurosurgical procedures, the use of a stereotactic frame is required; by using coordinates (x, y and z), which are computed and reported on the frame before the intervention, it is possible to set a precise target (dependent on the type of surgery) to be reached by the surgeon. For instance, during a Deep Brain Stimulation (DBS) performed in a patient suffering from Parkinson's disease (PD), the electrodes are introduced into the brain, deep down to the sub-thalamic nuclei (STN), which are situated in a very little area located in the upper brainstem. The mounting of the stereotactic frame on the patient's head is performed under local anesthesia (LA), as the patient is awake during the mounting procedure and later on during the surgical intervention. This mounting is done by screwing the device directly into the patient's skull, through the skin. This moment is reported as "painful" to "extremely painful" by patients, and most of them confess to keep a very unpleasant memory of the event, even several years after the procedure and despite the fact that the surgery had a positive effect on their functional outcome.

As exposed above, there is still room for improvement in the management of pain and comfort of patients undergoing functional procedures in neurosurgery, especially during the placement of the stereotactic frame. To our opinion, hypnosis could represent a serious therapy against pain and anxiety generated by the frame fixation, especially those whom facial expressions and feelings might be altered by their pathology (i.e. Parkinson's disease). In fact, this technique has already been abundantly reported as an important adjuvant to the management of pain and comfort during surgeries such as thyroidectomies) and resection of brain tumors.

The main objective of this study is to determine whether hypnosis is effective in decreasing the pain perceived by the patient during the placement of the stereotactic frame on the patient's head.

The secondary aims of this study are: 1) to measure the stress perceived during the procedure by submitting the patient to validated scores and 2) to evaluate the incidence of Post-traumatic Stress Disorder (PTSD), according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Parkinson Disease Tremor, Essential Dystonia, Primary

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Patients will be randomly attributed to either the "hypnosis" group or the control group, by a randomization process. The investigators plan to allocate patients in two groups; in the first group, patients will undergo hypnosis during the fixation of the stereotactic frame. In the second group (control group), the frame disposal will be performed following the actual standard of care, with a LA performed during the procedure.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

No masking

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Hypsnosis

During the fixation of the stereotactic frame, a single hypnosis session is performed by a certified senior anesthesiologist. Blood pressure, heart rate and respiratory rate are continuously monitored by the mean of a regular scope. Pain perceived during and after the procedure is quantifies by the mean of the Visual Analogue Scale (VAS) questionnaire. An open, standardized question will be asked to participants concerning feelings and thoughts about the frame fixation. Answers will be audio recorded. A standardized perceived distress questionnaire (PDI-13) will be performed.

Group Type EXPERIMENTAL

Hypnosis

Intervention Type PROCEDURE

Hypnosis session performed by a board certified senior anesthesiologist during the frame fixation on the patient's head.

Control

Local anesthesia after clear and complete information of the procedure given the day prior to the surgery. In order to determine the pain perceived during the procedure, a VAS questionnaire will be used, directly after the frame disposal. The rest of the procédure is similar to the hypnosis group.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Hypnosis

Hypnosis session performed by a board certified senior anesthesiologist during the frame fixation on the patient's head.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patients undergoing a stereotactic procedure as listed previously
* Patients ≥ 18 y.o.

Exclusion Criteria

* Patients \< 18 y.o.
* Patients unable to take decisions by their own
* Patients undergoing deep brain stimulation for obsessive-compulsive disease treatment
* Patients refusing to participate to the study
* Pregnancy
* Invasive monitoring of epilepsy
* Psychiatric comorbidity
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University Hospital, Geneva

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Marco Vincenzo Corniola

Chief Medical Officer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Marco Corniola

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Geneva

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Geneva University Hospital

Geneva, , Switzerland

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Switzerland

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Marco Corniola

Role: CONTACT

0795533770 ext. 0041

Sabina Catalano-Chiuvé

Role: CONTACT

022372837 ext. 0041

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Marco Corniola

Role: primary

795533770 ext. 0041

Sabina Catalano

Role: backup

0223728317 ext. 0041

References

Explore related publications, articles, or registry entries linked to this study.

Wang DD, Lau D, Rolston JD, Englot DJ, Sneed PK, McDermott MW. Pain experience using conventional versus angled anterior posts during stereotactic head frame placement for radiosurgery. J Clin Neurosci. 2014 Sep;21(9):1538-42. doi: 10.1016/j.jocn.2014.02.009. Epub 2014 May 6.

Reference Type BACKGROUND
PMID: 24814855 (View on PubMed)

Rahman M, Murad GJ, Mocco J. Early history of the stereotactic apparatus in neurosurgery. Neurosurg Focus. 2009 Sep;27(3):E12. doi: 10.3171/2009.7.FOCUS09118.

Reference Type BACKGROUND
PMID: 19722814 (View on PubMed)

Murata J, Sawamura Y, Kitagawa M, Saito H, Kikuchi S, Tashiro K. [Minimally invasive stereotactic functional surgery using an intravenous anesthetic propofol and applying Image Fusion and AtlasPlan]. No To Shinkei. 2001 May;53(5):457-62. Japanese.

Reference Type BACKGROUND
PMID: 11424357 (View on PubMed)

Venkatraghavan L, Manninen P, Mak P, Lukitto K, Hodaie M, Lozano A. Anesthesia for functional neurosurgery: review of complications. J Neurosurg Anesthesiol. 2006 Jan;18(1):64-7. doi: 10.1097/01.ana.0000181285.71597.e8.

Reference Type BACKGROUND
PMID: 16369142 (View on PubMed)

Stokes MA, Soriano SG, Tarbell NJ, Loeffler JS, Alexander E 3rd, Black PM, Rockoff MA. Anesthesia for stereotactic radiosurgery in children. J Neurosurg Anesthesiol. 1995 Apr;7(2):100-8. doi: 10.1097/00008506-199504000-00005.

Reference Type BACKGROUND
PMID: 7772962 (View on PubMed)

Benabid AL, Chabardes S, Mitrofanis J, Pollak P. Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease. Lancet Neurol. 2009 Jan;8(1):67-81. doi: 10.1016/S1474-4422(08)70291-6.

Reference Type BACKGROUND
PMID: 19081516 (View on PubMed)

Benabid AL, Chabardes S, Seigneuret E, Fraix V, Krack P, Pollak P, Xia R, Wallace B, Sauter F. Surgical therapy for Parkinson's disease. J Neural Transm Suppl. 2006;(70):383-92. doi: 10.1007/978-3-211-45295-0_58.

Reference Type BACKGROUND
PMID: 17017557 (View on PubMed)

Chevrier E, Fraix V, Krack P, Chabardes S, Benabid AL, Pollak P. Is there a role for physiotherapy during deep brain stimulation surgery in patients with Parkinson's disease? Eur J Neurol. 2006 May;13(5):496-8. doi: 10.1111/j.1468-1331.2006.01298.x.

Reference Type BACKGROUND
PMID: 16722975 (View on PubMed)

Fraix V, Pollak P, Chabardes S, Ardouin C, Koudsie A, Benazzouz A, Krack P, Batir A, Le Bas JF, Benabid AL. [Deep brain stimulation]. Rev Neurol (Paris). 2004 May;160(5 Pt 1):511-21. doi: 10.1016/s0035-3787(04)70980-7. French.

Reference Type BACKGROUND
PMID: 15269668 (View on PubMed)

Benabid AL, Pollak P, Hommel M, Gaio JM, de Rougemont J, Perret J. [Treatment of Parkinson tremor by chronic stimulation of the ventral intermediate nucleus of the thalamus]. Rev Neurol (Paris). 1989;145(4):320-3. French.

Reference Type BACKGROUND
PMID: 2660224 (View on PubMed)

Cojan Y, Waber L, Schwartz S, Rossier L, Forster A, Vuilleumier P. The brain under self-control: modulation of inhibitory and monitoring cortical networks during hypnotic paralysis. Neuron. 2009 Jun 25;62(6):862-75. doi: 10.1016/j.neuron.2009.05.021.

Reference Type BACKGROUND
PMID: 19555654 (View on PubMed)

Zemmoura I, Fournier E, El-Hage W, Jolly V, Destrieux C, Velut S. Hypnosis for Awake Surgery of Low-grade Gliomas: Description of the Method and Psychological Assessment. Neurosurgery. 2016 Jan;78(1):53-61. doi: 10.1227/NEU.0000000000000993.

Reference Type BACKGROUND
PMID: 26313220 (View on PubMed)

Tykocki T, Kornakiewicz A, Mandat T, Nauman P. Pain perception in patients with Parkinson's disease. J Clin Neurosci. 2013 May;20(5):663-6. doi: 10.1016/j.jocn.2012.05.043. Epub 2013 Feb 26.

Reference Type BACKGROUND
PMID: 23485408 (View on PubMed)

Watson R, Leslie K. Nerve blocks versus subcutaneous infiltration for stereotactic frame placement. Anesth Analg. 2001 Feb;92(2):424-7. doi: 10.1097/00000539-200102000-00028.

Reference Type BACKGROUND
PMID: 11159245 (View on PubMed)

Bellinghausen L, Collange J, Botella M, Emery JL, Albert E. [Factorial validation of the French scale for perceived stress in the workplace]. Sante Publique. 2009 Jul-Aug;21(4):365-73. French.

Reference Type BACKGROUND
PMID: 20101815 (View on PubMed)

Jehel L, Brunet A, Paterniti S, Guelfi JD. [Validation of the Peritraumatic Distress Inventory's French translation]. Can J Psychiatry. 2005 Jan;50(1):67-71. doi: 10.1177/070674370505000112. French.

Reference Type BACKGROUND
PMID: 15754668 (View on PubMed)

Catalano Chiuve S, Momjian S, Wolff A, Corniola MV. Effectiveness and reliability of hypnosis in stereotaxy: a randomized study. Acta Neurochir (Wien). 2024 Feb 27;166(1):112. doi: 10.1007/s00701-024-05943-0.

Reference Type DERIVED
PMID: 38411747 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2016-01843

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Agency in Dystonia
NCT03351218 COMPLETED NA