Infrared Images for Spinal Cord Stimulation in Complex Regional Pain Syndrome Patients

NCT ID: NCT05777889

Last Updated: 2024-12-27

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

Total Enrollment

10 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-02-22

Study Completion Date

2026-02-22

Brief Summary

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The goal of this observational study is to compare thermal camera Forward Looking InfraRed (FLIR) images before and after spinal cord stimulation to evaluate the difference in sympathetic activity of the affected limb in patients with complex regional pain syndrome (CRPS). The main questions it aims to answer are:

Question 1: Can Infrared (FLIR) imaging be used to monitor the sympatholytic activity caused by Spinal Cord Stimulation (SCS) in patients with CRPS?

Question 2: Is there any correlation between the quantification of sympatholytic activity produced by Spinal Cord Stimulation (SCS) and measured by FLIR imaging with the outcome measures in patients with CRPS? Outcome measures include pain (NRS), CRPS Severity Score (CSS), Quality of Life (SF-36), and neuropathic pain score (painDETECT).

Participants will have an image of their feet taken perpendicularly with a 1-inch space from all four sides using a FLIR T420 or T62101 camera with 320\*240 resolution.

Participants will also complete questionnaires about the average pain, CRPS severity, quality of life, and neuropathic pain.

Detailed Description

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Patients with CRPS often present with sympathetic dysfunction and peripheral vasomotor disturbances. Spinal Cord Stimulation (SCS) may have a sympatholytic effect with improved microcirculation and regional blood flow. This research proposal aims to investigate the potential use of Forward Looking Infrared (FLIR) imaging to monitor whether the sympatholytic effect is enhanced by using SCS in CRPS patients. The goal of this observational study is to compare thermal camera Forward Looking InfraRed (FLIR) images before and after spinal cord stimulation to evaluate the difference in sympathetic activity of the affected limb in patients with complex regional pain syndrome (CRPS). The main questions it aims to answer are:

Question 1: Can Infrared (FLIR) imaging be used to monitor the sympatholytic activity caused by Spinal Cord Stimulation (SCS) in patients with CRPS?

Question 2: Is there any correlation between the quantification of sympatholytic activity produced by Spinal Cord Stimulation (SCS) and measured by FLIR imaging with the outcome measures in patients with CRPS? Outcome measures include pain (NRS), CRPS Severity Score (CSS), Quality of Life (SF-36), and neuropathic pain score (painDETECT).

Participants will have an image of their feet taken perpendicularly with a 1-inch space from all four sides using a FLIR T420 or T62101 camera with 320\*240 resolution.

Participants will also complete questionnaires about the average pain, CRPS severity, quality of life, and neuropathic pain.

Conditions

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Complex Regional Pain Syndromes

Keywords

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spinal infrared

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Study CRPS Group

Enrolled patients with complex regional pain syndrome undergoing a surgical procedure that requires spinal cord stimulation.

All participants in the group will have an image of their feet taken perpendicularly with a 1-inch space from all four sides using a FLIR T420 or T62101 camera with 320\*240 resolution.

All participants will also answer questionnaires about: their average pain score, CRPS severity, quality of life, and neuropathic pain.

Forward Looking InfraRed Camera

Intervention Type OTHER

Forward Looking InfraRed Camera:

1. We will use a FLIR T420 or T62101 camera with a resolution of 320\*240.
2. Each image will be captured perpendicularly with a 1-inch gap on all four sides.
3. A Myler blanket placed in the background will separate the feet from the background.
4. The camera will be normalized to a temperature range of 15°C to 40°C.
5. The images will be saved in radiometric JPEG format.
6. Once the images have been transferred to a computer, we will remove the background.
7. Next, we'll make a temperature histogram with 0.1°C temperature bin resolution.
8. The before and after histograms (IB, IA) will be compared to see which one indicates more extreme temperature distributions.
9. Those who improve by 30% or more are considered to have had a successful spinal cord stimulation.

Interventions

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Forward Looking InfraRed Camera

Forward Looking InfraRed Camera:

1. We will use a FLIR T420 or T62101 camera with a resolution of 320\*240.
2. Each image will be captured perpendicularly with a 1-inch gap on all four sides.
3. A Myler blanket placed in the background will separate the feet from the background.
4. The camera will be normalized to a temperature range of 15°C to 40°C.
5. The images will be saved in radiometric JPEG format.
6. Once the images have been transferred to a computer, we will remove the background.
7. Next, we'll make a temperature histogram with 0.1°C temperature bin resolution.
8. The before and after histograms (IB, IA) will be compared to see which one indicates more extreme temperature distributions.
9. Those who improve by 30% or more are considered to have had a successful spinal cord stimulation.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* The patient is between 18 and 85 years old
* Providing CRPS diagnostic criteria by using the Budapest Clinical Diagnostic Criteria.
* The patient has had pain and other symptoms for more than 3 months
* Not responding to conventional medical treatments and multidisciplinary approach
* High NRS detection in pain assessment despite appropriate treatment (NRS= and \> 6/10).
* Pain causing a limitation in the patient's functional capacity despite appropriate treatment.

Exclusion Criteria

* Patients with suspected disc herniation, spinal stenosis, myelopathy, and suspected radiculopathy in detailed examinations and examinations (MRI, CT).
* Systemic or local infection
* Coagulation disorders
* History of allergy to contrast material
* Malignancy
* Pregnancy
* Uncontrollable medical and psychiatric condition
* The patients diagnosed with dysautonomia, sympathetic dysfunction other than CRPS (such as Raynaud disease or Buerger disease), sweating disorders other than CRPS (such as acquired idiopathic generalized anhidrosis), and patients
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital for Special Surgery, New York

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Semih Gungor, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital for Special Surgery, New York

Locations

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Hospital for Special Surgery

New York, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Pa Thor, PhD

Role: CONTACT

Phone: 646-797-8535

Email: [email protected]

Facility Contacts

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Justas Lauzadis, PhD

Role: primary

References

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Harden RN, McCabe CS, Goebel A, Massey M, Suvar T, Grieve S, Bruehl S. Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 5th Edition. Pain Med. 2022 Jun 10;23(Suppl 1):S1-S53. doi: 10.1093/pm/pnac046.

Reference Type RESULT
PMID: 35687369 (View on PubMed)

Baron R, Schattschneider J, Binder A, Siebrecht D, Wasner G. Relation between sympathetic vasoconstrictor activity and pain and hyperalgesia in complex regional pain syndromes: a case-control study. Lancet. 2002 May 11;359(9318):1655-60. doi: 10.1016/S0140-6736(02)08589-6.

Reference Type RESULT
PMID: 12020526 (View on PubMed)

Croom JE, Foreman RD, Chandler MJ, Barron KW. Cutaneous vasodilation during dorsal column stimulation is mediated by dorsal roots and CGRP. Am J Physiol. 1997 Feb;272(2 Pt 2):H950-7. doi: 10.1152/ajpheart.1997.272.2.H950.

Reference Type RESULT
PMID: 9124459 (View on PubMed)

Jacobs MJ, Jorning PJ, Joshi SR, Kitslaar PJ, Slaaf DW, Reneman RS. Epidural spinal cord electrical stimulation improves microvascular blood flow in severe limb ischemia. Ann Surg. 1988 Feb;207(2):179-83. doi: 10.1097/00000658-198802000-00011.

Reference Type RESULT
PMID: 3257679 (View on PubMed)

Linderoth B, Fedorcsak I, Meyerson BA. Peripheral vasodilatation after spinal cord stimulation: animal studies of putative effector mechanisms. Neurosurgery. 1991 Feb;28(2):187-95.

Reference Type RESULT
PMID: 1671794 (View on PubMed)

Huh BK, Park CH, Ranson M, Campbell GL, Ravanbakht J. Thermogram in spinal cord stimulation with complex regional pain syndrome and a review of the literature. Neuromodulation. 2010 Apr;13(2):114-6. doi: 10.1111/j.1525-1403.2009.00236.x. Epub 2009 Sep 3.

Reference Type RESULT
PMID: 21992784 (View on PubMed)

Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR. Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med. 2007 May-Jun;8(4):326-31. doi: 10.1111/j.1526-4637.2006.00169.x.

Reference Type RESULT
PMID: 17610454 (View on PubMed)

Harden NR, Bruehl S, Perez RSGM, Birklein F, Marinus J, Maihofner C, Lubenow T, Buvanendran A, Mackey S, Graciosa J, Mogilevski M, Ramsden C, Schlereth T, Chont M, Vatine JJ. Development of a severity score for CRPS. Pain. 2010 Dec;151(3):870-876. doi: 10.1016/j.pain.2010.09.031. Epub 2010 Oct 20.

Reference Type RESULT
PMID: 20965657 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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2022-2480

Identifier Type: -

Identifier Source: org_study_id