Effects of tDCS Combined With CBI on Postsurgical Pain

NCT ID: NCT04199780

Last Updated: 2025-07-30

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

RECRUITING

Clinical Phase

NA

Total Enrollment

132 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-11

Study Completion Date

2026-07-31

Brief Summary

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The purpose of this study is to determine whether a new medical technology can help reduce post-operative total knee or hip pain when combined with a Cognitive-Behavioral intervention (CBI).

This new medical technology, is called transcranial direct current stimulation (tDCS), it uses a very small amount of electricity to temporarily stimulate specific areas of the brain thought to be involved in pain reduction. The electrical current passes through the skin, scalp, hair, and skull and requires no additional medication, sedation, or needles.

This study will investigate the effects of tDCS, the Cognitive-Behavioral (CB) intervention and their combination on pain among veterans following total knee arthroplasty (TKA) or total hip arthroplasty (THA). The Veteran may benefit in the form of decreased pain and opioid requirements following knee or hip replacement surgery. However, benefit is only likely if Veterans are randomized to one of the 3 (out of 4) groups.

This study hopes to determine the effects of these interventions and combined effect on post-operative pain, opioid use and functioning during the 48-hour post-operative period following a total knee or hip replacement.

Detailed Description

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The proposed study employs a randomized, double-blind, sham-controlled design to evaluate the effects of tDCS, brief Cognitive-Behavioral (CB) intervention and their combination on pain among veterans undergoing unilateral TKA or THA. 132 patients undergoing TKA/THA will be randomly assigned to one of four groups:

1. Group1- real tDCS + real CB intervention
2. Group2- real tDCS + education-only-control intervention
3. Group3- sham tDCS + real CB intervention
4. Group4- sham tDCS +education-only-control intervention

Participants will receive 2 tDCS/CBI treatments on the day of their surgery, and 2 tDCS/CBI treatments the day after their surgery. Participants' perioperative medication usage and pain ratings will be tracked during postoperative hospital stay. Follow-up data regarding pain and opioid use will be collected at 1, 3 and 6-months.

Conditions

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Total Knee Arthroplasty (Postoperative Pain) Total Hip Arthroplasty (Postoperative Pain)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Group 1- real tDCS and real CBI

4 active treatments of tDCS and active cognitive behavioral intervention (CBI)

Group Type EXPERIMENTAL

Transcranial Direct Current Stimulation

Intervention Type DEVICE

Transcranial direct current stimulation (tDCS), stimulates specific areas of the brain via electric current passed through electrodes placed on the scalp. During tDCS, low amplitude direct currents penetrates the skull to enter the brain and modulates neuronal activity.

Cognitive-Behavioral (CB) intervention

Intervention Type BEHAVIORAL

CBI generally consist of cognitive coping strategies (e.g., distraction, relabeling, reducing pain-catastrophizing) and self-management (e.g., relaxation strategies, guided imagery) designed to enhance perceived control and reduce sympathetic nervous system tone.

Group 2- real tDCS and sham CBI

4 active treatments of tDCS and education-only-control cognitive intervention

Group Type EXPERIMENTAL

Transcranial Direct Current Stimulation

Intervention Type DEVICE

Transcranial direct current stimulation (tDCS), stimulates specific areas of the brain via electric current passed through electrodes placed on the scalp. During tDCS, low amplitude direct currents penetrates the skull to enter the brain and modulates neuronal activity.

Cognitive-Behavioral (CB) intervention

Intervention Type BEHAVIORAL

CBI generally consist of cognitive coping strategies (e.g., distraction, relabeling, reducing pain-catastrophizing) and self-management (e.g., relaxation strategies, guided imagery) designed to enhance perceived control and reduce sympathetic nervous system tone.

Group 3- sham tDCS and real CBI

4 sham treatments of tDCS and active cognitive behavioral intervention (CBI)

Group Type EXPERIMENTAL

Transcranial Direct Current Stimulation

Intervention Type DEVICE

Transcranial direct current stimulation (tDCS), stimulates specific areas of the brain via electric current passed through electrodes placed on the scalp. During tDCS, low amplitude direct currents penetrates the skull to enter the brain and modulates neuronal activity.

Cognitive-Behavioral (CB) intervention

Intervention Type BEHAVIORAL

CBI generally consist of cognitive coping strategies (e.g., distraction, relabeling, reducing pain-catastrophizing) and self-management (e.g., relaxation strategies, guided imagery) designed to enhance perceived control and reduce sympathetic nervous system tone.

Group 4- sham tDCS and sham CBI

4 sham treatments of tDCS and education-only-control cognitive intervention

Group Type SHAM_COMPARATOR

Transcranial Direct Current Stimulation

Intervention Type DEVICE

Transcranial direct current stimulation (tDCS), stimulates specific areas of the brain via electric current passed through electrodes placed on the scalp. During tDCS, low amplitude direct currents penetrates the skull to enter the brain and modulates neuronal activity.

Cognitive-Behavioral (CB) intervention

Intervention Type BEHAVIORAL

CBI generally consist of cognitive coping strategies (e.g., distraction, relabeling, reducing pain-catastrophizing) and self-management (e.g., relaxation strategies, guided imagery) designed to enhance perceived control and reduce sympathetic nervous system tone.

Interventions

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Transcranial Direct Current Stimulation

Transcranial direct current stimulation (tDCS), stimulates specific areas of the brain via electric current passed through electrodes placed on the scalp. During tDCS, low amplitude direct currents penetrates the skull to enter the brain and modulates neuronal activity.

Intervention Type DEVICE

Cognitive-Behavioral (CB) intervention

CBI generally consist of cognitive coping strategies (e.g., distraction, relabeling, reducing pain-catastrophizing) and self-management (e.g., relaxation strategies, guided imagery) designed to enhance perceived control and reduce sympathetic nervous system tone.

Intervention Type BEHAVIORAL

Other Intervention Names

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tDCS CBI

Eligibility Criteria

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Inclusion Criteria

Participants will be 120 patients (132 recruited to account for 10% drop-out rate) undergoing TKA or THA surgery at the Ralph H. Johnson VAMC in Charleston SC.

* Mentally capable of reading, writing, giving consent, and following instructions
* Cleared for, and scheduled for unilateral TKA or THA surgery
* Able to hear CB intervention and understand educational materials through headphones in English

Exclusion Criteria

* implanted medical devices above the waist
* pregnant
* history of seizures
* allergic to latex rubber
* psychiatric conditions except for depression and/or anxiety disorders (commonly seen in this population).
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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VA Office of Research and Development

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jeffrey J Borckardt, PhD

Role: PRINCIPAL_INVESTIGATOR

Ralph H. Johnson VA Medical Center, Charleston, SC

Locations

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Ralph H. Johnson VA Medical Center, Charleston, SC

Charleston, South Carolina, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jeffrey J Borckardt, PhD

Role: CONTACT

(843) 577-5011 ext. 5854

Donald (Hugh) L Myrick, MD BS

Role: CONTACT

(843) 789-7316

Facility Contacts

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Jeffrey J Borckardt, PhD

Role: primary

843-577-5011 ext. 5854

Donald (Hugh) L Myrick, MD BS

Role: backup

(843) 789-7316

Other Identifiers

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CX001996

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

NURB-001-19S

Identifier Type: -

Identifier Source: org_study_id

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