Pivotal-Safety and Therapeutic Measures of tDCS in Patients With Refractory Focal Epilepsy

NCT ID: NCT04770337

Last Updated: 2024-11-18

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

190 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-25

Study Completion Date

2026-07-31

Brief Summary

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This is a multiple site, randomized, double blinded parallel-group controlled study. The purpose of this study is to evaluate efficacy, safety, and tolerability of repeated, daily sessions with the STARSTIM device, which delivers transcranial cathodal direct current stimulation (tDCS). Subjects will be treated with STARTSTIM or sham device for 10 sessions over a 2-week period. The subjects will be followed for an additional 10 weeks post treatment. Quality of Life questionnaires and adverse events will be collected and evaluated.

Detailed Description

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Study design is an evaluation of the STARSTIM device (tDCS) in subjects over 9 years of age, diagnosed with epilepsy with focal seizures with or without focal to bilateral tonic clonic seizures. Seizure diaries will be collected for 12 weeks to establish a rate of seizure for each subject prior to treatment. Subjects will be randomized in a 1:1 ratio to receive an active STARSTIM treatment or a sham treatment. Neither the study investigator nor subject shall be notified of the treatment assignment. Treatment will be done daily at the investigator's site for 10 days. A Seizure Diary will be maintained through the course of the treatment and the follow up period. Subjects will have 3 follow up visits to evaluate their seizure rate, adverse events, medications and quality of life. A Data Safety Monitoring Board will be utilized to evaluate safety events through study milestones. Seizure frequency rates pre, during and post treatment will be evaluated for both the active and sham treatment arms.

Conditions

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Refractory Epilepsy Focal Seizure Seizures, Focal Seizures Epilepsy in Children Epilepsy Epilepsy, Tonic-Clonic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

multiple site, randomized, double blinded parallel-group controlled study
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Subjects will be randomized in a 1:1 ratio to receive an active STARSTIM treatment or a sham treatment. Neither the study investigator nor subject shall be notified of the treatment assignment.

Study Groups

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Sham treatment

Subjects will be randomized in a 1:1 ratio to receive an active STARSTIM treatment or a sham treatment.

Group Type SHAM_COMPARATOR

Sham Device

Intervention Type DEVICE

Intervention which uses enough currents to generate a sensory feedback similar to that of active stimulation via electrodes on the scalp

STARSTIM device treatment

Subjects will be randomized in a 1:1 ratio to receive an active STARSTIM treatment or a sham treatment.

Group Type EXPERIMENTAL

STARSTIM device

Intervention Type DEVICE

Cathodal Transcranial Direct Current Stimulation (tDCS). Transcranial direct current stimulation (tDCS) is a form of neurostimulation which uses constant, low current delivered to the brain area of interest via electrodes on the scalp.

Interventions

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STARSTIM device

Cathodal Transcranial Direct Current Stimulation (tDCS). Transcranial direct current stimulation (tDCS) is a form of neurostimulation which uses constant, low current delivered to the brain area of interest via electrodes on the scalp.

Intervention Type DEVICE

Sham Device

Intervention which uses enough currents to generate a sensory feedback similar to that of active stimulation via electrodes on the scalp

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. 9 years old or older
2. Diagnosis of epilepsy with focal seizures with or without focal to bilateral tonic clonic seizures (International League Against Epilepsy classification). Diagnosis established by both clinical history and an EEG consistent with focal seizures.

Note: A normal interictal EEG is consistent with focal seizures, if other data is adequate to provide localization.
3. Epilepsy is refractory to treatment, defined as: failure to achieve adequate seizure control despite demonstrated compliance, according to medical records, on at least two (2) FDA-approved ASDs at a daily dose considered therapeutic for the patient's demographic according to package labeling, within approximately the last 3 years.
4. Seizure frequency ≥3 per month, over the past year.
5. Currently on ≥1 ASDs with no changes in antiepileptic drug doses in the 3 weeks prior to baseline visit in the study and no planned dose changes during the trial. Changes after baseline visit are permitted only if clinically necessary.
6. An MRI scan of the brain using 1.5 Tesla magnet, or greater, with T1, T2, and FLAIR sequences, performed within past 3 years and more recently than any craniotomy or skull burr hole procedure.
7. Seizure focus that allows design of an appropriate stimulation montage. Note: Seizure focus can be identified within a lobe, or 2 adjacent lobes. Identification of the border of the seizure focus can be approximate (+/- 2 gyri).
8. Available seizure history and supporting data
9. All female study subjects of child-bearing age are required to have a pregnancy test. Additionally, all females of childbearing potential will be required to use an effective method of birth control (defined as having a documented failure rate of \<=1%; for women using enzyme-inducing ASDs hormonal contraceptives will not be considered as effective).
10. Written informed consent obtained from study subject or subject's legal representative and ability for study subject to comply with the requirements of the study.
11. Assent from pediatric subjects when appropriate.

Exclusion Criteria

1. Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the subject or the integrity of the data.
2. Evidence for more than one seizure focus. (NOTE: For this study, a seizure focus is defined as a cortical region confined to one hemisphere and either one lobe or on a junction of two adjacent lobes from which seizures arise , as documented by scalp or intracranial EEG, that is either supported or not refuted by MRI, and either supported or not refuted by clinical semiology). If the interictal EEG is normal, a seizure focus may be identified by the combination of structural findings on MRI and clinical signs/symptoms associated with the subject's seizures.
3. Seizure focus is one of: interhemispheric, cingulate, or orbitofrontal
4. Seizure focus is hemispheric or poorly defined
5. History of psychogenic nonepileptic seizures in past 2 years, or physiologic nonepileptic seizures and non-epileptogenic events, including suspicion for or a significant history of syncope, and any non-epileptic events must be clearly differentiable from subject's focal seizures based on previously recorded video EEG showing distinct clinical and electrographic features of the subject's PNES compared to their epileptic seizures.
6. Seizures of generalized onset
7. Status epilepticus in the last 12 months
8. Presence of any disease, medical condition or physical condition that, in the opinion of the Investigator, may compromise interfere, limit, affect or reduce the subject's ability to complete a study of 24 weeks duration
9. Presence of any disease, medical condition or physical condition that, in the opinion of the Investigator, may adversely impact the safety of the subject or the integrity of the data.
10. Damaged skin on scalp that may interfere with tDCS stimulation.
11. Pregnant or unwilling to practice birth control during participation in the study.
12. Nursing mothers.
13. Any cranial metal implants (excluding ≦1 mm thick epicranial titanium skull plates and dental fillings) or medical devices (i.e. cardiac pacemaker, deep brain stimulator, medication infusion pump, cochlear implant). Note: Vagus nerve stimulator (VNS) is allowable if the device is in MR Mode (e.g. switched off) during tDCS stimulation and the VNS device is MR conditional.
14. Previous surgeries opening the skull leaving skull defects capable of allowing the insertion of a cylinder with a radius greater or equal to 5 mm.
15. A history of addiction to, dependence on, abuse of, misuse of, distribution of, or use of any illicit substance.
Minimum Eligible Age

9 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Neuroelectrics Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Barrow Neurological Institute, St. Joseph's Hospital & Medical Center

Phoenix, Arizona, United States

Site Status RECRUITING

Loma Linda University Health

Loma Linda, California, United States

Site Status RECRUITING

Keck Medicine of USC

Los Angeles, California, United States

Site Status RECRUITING

Children's Hospital of Orange County

Orange, California, United States

Site Status TERMINATED

University of Florida Jacksonville

Jacksonville, Florida, United States

Site Status RECRUITING

Southern Illinois University School of Medicine

Springfield, Illinois, United States

Site Status TERMINATED

Sinai Hospital

Baltimore, Maryland, United States

Site Status RECRUITING

Johns Hopkins University

Baltimore, Maryland, United States

Site Status RECRUITING

Boston Children's Hospital Comprehensive Epilepsy Center

Boston, Massachusetts, United States

Site Status RECRUITING

Beth Israel Deconess Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

Mayo Clinic

Rochester, Minnesota, United States

Site Status RECRUITING

Washington University Medical Center

St Louis, Missouri, United States

Site Status RECRUITING

Robert Wood Johnson Medical School (Rutgers)

New Brunswick, New Jersey, United States

Site Status RECRUITING

University of Rochester

Rochester, New York, United States

Site Status RECRUITING

University of Pennsylvania (Penn Epilepsy)

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status RECRUITING

University Of Utah

Salt Lake City, Utah, United States

Site Status TERMINATED

Seattle Children's Hospital, University of Washington

Seattle, Washington, United States

Site Status TERMINATED

Cliniques Universitaires Saint Luc

Brussels, , Belgium

Site Status RECRUITING

Ghent University Hospital

Ghent, , Belgium

Site Status RECRUITING

Hospices Civils De Lyon

Lyon, , France

Site Status RECRUITING

CHU de Marseille - Hôpital de la Timone

Marseille, , France

Site Status RECRUITING

Hospital Universitario Albacete

Albacete, , Spain

Site Status RECRUITING

HM Nou Delfos

Barcelona, , Spain

Site Status RECRUITING

Hospital Clínic

Barcelona, , Spain

Site Status RECRUITING

Hospital Del Mar

Barcelona, , Spain

Site Status RECRUITING

Hospital Sant Joan de Déu

Barcelona, , Spain

Site Status RECRUITING

Hospital Universitari Vall d'Hebron

Barcelona, , Spain

Site Status RECRUITING

Hospital Niño Jesús

Madrid, , Spain

Site Status RECRUITING

Hospital Ruber Internacional

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario Regional de Málaga

Málaga, , Spain

Site Status RECRUITING

Centro de Neurología Avanzada

Seville, , Spain

Site Status RECRUITING

Countries

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United States Belgium France Spain

Central Contacts

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Julia Casanovas, Engineer

Role: CONTACT

34 93 254 03 66

Thaïs Baleeiro, PhD

Role: CONTACT

34 93 254 03 66

Facility Contacts

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Susan Herman, M.D

Role: primary

Karuna Sehdev, SRC

Role: backup

602-406-7401

Firas Bannout, M.D

Role: primary

David Borg, CRC

Role: backup

(909) 558-2037

Charles Liu, M.D

Role: primary

Joanne Gibbons, CRC

Role: backup

(818) 284-1626

Katherine Zarroli, M.D

Role: primary

Yasmeen Shabbir, CRC

Role: backup

904-244-9856

Arash Foroughi, M.D

Role: primary

Seanne Facho, CRC

Role: backup

410.601.0960

Gregory Krauss, M.D

Role: primary

Pam Coe, SRC

Role: backup

410-502-5570

Alexander Rotenberg, M.D

Role: primary

Paul MacMullin, CRC

Role: backup

(617) 355-7970

Mo Shafi, M.D

Role: primary

Lucia Leblanc Perez, CRC

Role: backup

617-632-8934

Brian Lundstrom, M.D

Role: primary

Carey Huebert, CRC

Role: backup

507-293-1120

Robert Hogan, M.D

Role: primary

Patty Schaefer, CRC

Role: backup

314-362-7871

Ram Mani, M.D

Role: primary

Asha Cilly, CRC

Role: backup

732-235-7342

Trent Tollefson, M.D

Role: primary

Noreen L Connolly, CRC

Role: backup

(585) 275-0589

Mindy Ganguly, M.D

Role: primary

Melissa Johnston Esparza, CRC

Role: backup

(215) 662-7227

Abou-Khalil Bassel, M.D

Role: primary

Melissa Osborn, CRC

Role: backup

615-936-0209

Riëm El Tahry, M.D

Role: primary

Role: primary

+32 93224539

Sylvain Rheims, M.D

Role: primary

Fabrice Bartolomei, M.D

Role: primary

Role: primary

+34 670 58 65 94

Role: primary

+34 662054748

Mar Carreño, M.D

Role: primary

Rodrigo Rocamora, M.D

Role: primary

Alejandra Climent, M.D

Role: primary

Manuel Toledo, M.D

Role: primary

Role: primary

+34 915035900

Antonio Gil Nagel, M.D

Role: primary

Role: primary

+34 638583141

Role: primary

+34 959540820

Other Identifiers

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NE001

Identifier Type: -

Identifier Source: org_study_id

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