Neurophysiological Mechanisms Involved in Knee Osteoarthritis

NCT ID: NCT03556423

Last Updated: 2022-05-27

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 28 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2018-07-01
• Study Completion Date: 2022-03-01

Brief Summary

Introduction: Total knee arthroplasty (TKA) is an effective intervention to relieve people with osteoarthritis (OA). Nevertheless, 15 to 30% of patients continue to experience severe pain following surgery. Recent data suggest that central nervous system (CNS) changes may play a role in OA pain and possibly explain why some patients have poorer clinical outcomes following TKA. Objectives: Our main objectives are to explore the relationship between OA pain and (1) the integrity of corticospinal system, (2) the efficacy of descending pain inhibition circuits. Methods: Fifty-two patients waiting for TKA will be recruited. The integrity of the corticospinal projections will be measured using transcranial magnetic stimulation (recruitment curve of the affected quadriceps femoris muscle) and the descending pain inhibition circuits (bulbospinal projections) will be assessed by a counter-irritation paradigm (i.e., conditioned pain modulation with immersion of the arm in painfully cold water). Diffuse tension imaging (DTI) will also be used to quantify the strength of these corticospinal and bulbospinal projections. Clinical outcomes will be evaluated before and after arthroplasty with a series of validated questionnaires such as the WOMAC Scale, the McGill Pain Questionnaire and the Brief Pain Inventory. These different neurophysiological and clinical measures will be taken before surgery, 6 months after surgery and 1 year post-surgery. Anticipated results: The investigators expect a moderate association between pain and the strength of the corticospinal and bulbospinal projections. Moreover, it is expected that there will be a moderate association between the strength of the corticospinal/bulbospinal projections and the clinical evolution of patients.

Detailed Description

See outcome measures

Conditions

Knee Osteoarthritis; Chronic Pain

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Eligibility Criteria

Inclusion Criteria

• Being an adults aged 50-79 years old with a diagnosis of knee OA and waiting for a primary arthroplasty
• Refrain from consuming cigarettes and caffeine 2 hours and 6 hours before testing, respectively
• Refrain from taking short-acting analgesics (e.g., acetaminophen) 6 hours before testing

Exclusion Criteria

• Having difficulty understanding french language
• Having a diagnosis of neurological disorder or diagnosis of chronic pain (other knee OA)
• Having metal implants in the skull
• Having pacemaker or neurostimulator
• Being pregnant
• Being epileptic

• Minimum Eligible Age: 50 Years
• Maximum Eligible Age: 79 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Université de Sherbrooke

OTHER

Sponsor Role: lead

Responsible Party

Guillaume Léonard

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Guillaume Leonard, Ph.D., pht.

Role: PRINCIPAL_INVESTIGATOR

Centre de Recherche sur le Vieillissement (CdRV)

Locations

Centre de recherche sur le vieillissement (CdRV)

Sherbrooke, Quebec, Canada

CRCHUS: Centre de recherche du centre hospitalier universitaire de Sherbrooke

Sherbrooke, Quebec, Canada

Countries

Canada

Other Identifiers

2015-454-IUGS

Identifier Type: -

Identifier Source: org_study_id