A High Frequency Spinal Cord Stimulation PET-CT Scan Study

NCT ID: NCT03716557

Last Updated: 2025-01-09

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

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-09

Study Completion Date

2020-01-31

Brief Summary

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This study aims to investigate the clinical response to Spinal Cord Stimulation frequency parameters: 40Hz, 4000Hz and 10000Hz and explore the brain imaging changes using PET-CT scans. The response to these stimulator settings on health related quality of life will also be measured using validated questionnaires.

Detailed Description

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Spinal cord stimulation (SCS) is a treatment option for people suffering with chronic neuropathic back and leg pain. Conventionally, patients receiving SCS are provided with tonic stimulation parameters, where the frequency of electrical pulses is set at 40-60Hz. The major side effect of tonic SCS parameters is the onset of paraesthesia, a tingling or pins and needles sensation within the target region, which can cause discomfort for some patients. However, newer methods include high-frequency stimulation (HF) which is able to provide paraesthesia free stimulation, ultimately providing better patient tolerability. HF stimulation is widely offered to patients with SCS as part of routine clinical practice. However, the effect on pathways in the brain remains to be characterised. This study therefore aims to investigate the clinical response to three frequency parameters 40Hz, 4000Hz and 10000Hz and also explore the brain imaging changes using PET-CT scans. The response to these stimulator settings on health related quality of life will also be measured using validated questionnaires.

20 patients who are deemed suitable for SCS as part of NICE guidelines 159 pathway will be recruited for the study. All patients will have a baseline PET-CT scan and undergo first stage of SCS where they will be offered tonic 40Hz settings as part of trial stimulation. If successful (\>50% improvement in pain scores) patients will be offered second stage and continue to receive 40Hz stimulation for 4 weeks. After a second PET-CT scan they are randomised to receive either 4000Hz or 10000Hz stimulation for 4 more weeks, then cross-over treatment for another 4 weeks. PET-CT scans will be performed between each level of stimulation and at the end of the study (4 in total).

Conditions

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Neuropathic Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Single-blind crossover design
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Spinal Cord Stimulation 4000Hz

Patients will trial Spinal Cord Stimulation 4000Hz for 4 weeks. PET/CT scan will be conducted at the end of this period.

Group Type EXPERIMENTAL

Spinal Cord Stimulation 4000Hz

Intervention Type DEVICE

Differential programming of the Boston Scientific Precision™ Plus Spinal Cord Stimulator System

Spinal Cord Stimulation 10000Hz

Patients will trial Spinal Cord Stimulation 10,000Hz for 4 weeks. PET/CT scan will be conducted at the end of this period.

Group Type EXPERIMENTAL

Spinal Cord Stimulation 10000Hz

Intervention Type DEVICE

Differential programming of the Boston Scientific Precision™ Plus Spinal Cord Stimulator System

Spinal Cord Stimulation 40Hz

Patients will trial Spinal Cord Stimulation 10,000Hz for 4 weeks. PET/CT scan will be conducted at the end of this period.

Group Type ACTIVE_COMPARATOR

Spinal Cord Stimulation 40Hz

Intervention Type DEVICE

Differential programming of the Boston Scientific Precision™ Plus Spinal Cord Stimulator System

Interventions

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Spinal Cord Stimulation 4000Hz

Differential programming of the Boston Scientific Precision™ Plus Spinal Cord Stimulator System

Intervention Type DEVICE

Spinal Cord Stimulation 10000Hz

Differential programming of the Boston Scientific Precision™ Plus Spinal Cord Stimulator System

Intervention Type DEVICE

Spinal Cord Stimulation 40Hz

Differential programming of the Boston Scientific Precision™ Plus Spinal Cord Stimulator System

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with intractable lumbar neuropathic pain who are due to receive Percutaneous Spinal Cord Stimulation as part of their standard treatment per NICE HTA guidance 159 at Barts Health NHS Hospitals.
* Patients between 18 and 75 years of age.
* Patients who have given their written informed consent.
* Female patients of childbearing potential must be using adequate contraception (i.e. using oral or IM contraception or an IUCD) and must have a negative urine pregnancy test.
* Patients must be able to communicate in English in order to complete validated questionnaires written in English only.

Exclusion Criteria

* Patients with diabetes or any underlying neurological condition.
* Patients known to have a condition that in the investigator's judgement precludes participation in the study.
* Patients who have received an investigational drug or have used an investigational device in the 30 days preceding study entry.
* Patients unable to comply with the study assessments and to complete the questionnaires.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Scientific Corporation

INDUSTRY

Sponsor Role collaborator

Barts & The London NHS Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Vivek Mehta, MD

Role: PRINCIPAL_INVESTIGATOR

Barts & The London NHS Trust

Locations

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Barts Health NHS Trust

London, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Poply K, Haroon A, Ganeshan B, Nikolic S, Sharma S, Ahmad A, Ellamushi H, Parsai A, Mehta V. Dynamic Brain Imaging Response to Spinal Cord Stimulation Differential Frequencies DiFY SCS-PET Clinical Trial. Neuromodulation. 2023 Jul;26(5):988-998. doi: 10.1016/j.neurom.2022.07.012. Epub 2022 Sep 21.

Reference Type DERIVED
PMID: 36151010 (View on PubMed)

Other Identifiers

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011768

Identifier Type: -

Identifier Source: org_study_id

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