Is Nociceptive Processing Evoked by Heat Homeostatically Regulated: A Contact-heat Evoked Potentials Study
NCT ID: NCT06197529
Last Updated: 2024-05-16
Study Results
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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COMPLETED
NA
18 participants
INTERVENTIONAL
2023-11-21
2024-03-04
Brief Summary
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In healthy subjects, homeostatic plasticity induction over the primary motor cortex increases the amplitude of motor-evoked potentials after the first block of excitatory tDCS, which then decreases after the second block of excitatory tDCS. However, this mechanism is impaired in chronic and experimental pain, demonstrated by an increase in excitability instead of a reversal.
The role of homeostatic plasticity mechanisms in pain is yet to be unraveled, but homeostatic plasticity may hold an important role in pain development or persistence.
Thus, the aim of this study is to investigate if the cortical nociceptive response reflected by contact heat stimulation (CHEPs) is regulated by homeostatic mechanisms. For this, homeostatic plasticity will be induced in both the primary motor (M1) and sensory cortices (S1). The first research question will explore if the contact heat evoked potentials are homeostatically regulated and if this regulation is occurring locally or globally in the cortex. Additionally, it will be investigated if and how capsaicin-induced nociception interacts and effects the homeostatic response as reflected by CHEPs.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
CROSSOVER
BASIC_SCIENCE
SINGLE
Study Groups
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S1 Homeostatic Plasticity-Pain
Anodal tDCS CP3 1mA FP2 -1mA
4x4 patch on the dorsum of the hand
Homeostatic Plasticity
Anodal tDCS S1/M1
Topical alone (Capsaicin 8% Patch)
4x4 patch
S1 Homeostatic Plasticity-NoPain
Anodal tDCS C3 1mA FP2 -1mA
4x4 patch on the dorsum of the hand
Homeostatic Plasticity
Anodal tDCS S1/M1
Placebo Patch
4x4 patch
S1 Homeostatic Plasticity-Sham
Sham tDCS C3 FP2
4x4 patch on the dorsum of the hand
Placebo Patch
4x4 patch
Homeostatic Plasticity (Sham)
sham Homeostatic Plasticity protocol over S1
M1 Homeostatic Plasticity
Anodal tDCS C3 1mA FP2 -1mA
4x4 patch on the dorsum of the hand
Homeostatic Plasticity
Anodal tDCS S1/M1
Placebo Patch
4x4 patch
Interventions
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Homeostatic Plasticity
Anodal tDCS S1/M1
Topical alone (Capsaicin 8% Patch)
4x4 patch
Placebo Patch
4x4 patch
Homeostatic Plasticity (Sham)
sham Homeostatic Plasticity protocol over S1
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Speak, read, and understand English or Danish
Exclusion Criteria
* Regular use of cannabis, opioids or other drugs (except contraceptives)
* Current or previous neurologic, musculoskeletal, mental, or other illnesses (e.g. brain or spinal cord injuries, degenerative neurological disorders, epilepsy, major depression, cardiovascular disease, chronic lung disease, etc.)
* Current or previous chronic or recurrent pain condition (other than low back pain in patients recruited for sub-project 6, and this item does not apply to sub-project 8)
* Current regular use of analgesic medication or other medication which may affect the trial (including paracetamol and NSAIDs) For subproject 8, chronic low back pain patients may take analgesic medication provided the dosage is stable
* Open wounds, eczema, scars, or tattoos in the area of the heat stimulation (sub-project 1)
* Lack of ability to cooperate
* Recent history of acute pain particularly in the lower limbs (unless related to low back pain in patients included in sub-project 6 or 8)
* Abnormally disrupted sleep in 24 hours preceding experiment
* Any medical or other condition (i.e. musculoskeletal, cardiorespiratory, neurological, etc.)
* Contraindications to TMS application (history of epilepsy, metal implants in head or jaw, etc.)
* Unable to answer to the "Transcranial Magnetic Stimulation Adult Safety Screen" or tDCS screening questionnaire (see Bilag\_v1\_06092021)
18 Years
60 Years
ALL
Yes
Sponsors
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Aalborg University
OTHER
Responsible Party
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Daniela Montemayor Zolezzi
Principal Investigator
Principal Investigators
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Thomas Graven-Nielsen, PhD, DMSc
Role: STUDY_DIRECTOR
Aalborg University
Locations
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Aalborg University / Center for Neuroplasticity and Pain
Gistrup, , Denmark
Countries
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References
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Wittkopf PG, Larsen DB, Gregoret L, Graven-Nielsen T. Prolonged corticomotor homeostatic plasticity - Effects of different protocols and their reliability. Brain Stimul. 2021 Mar-Apr;14(2):327-329. doi: 10.1016/j.brs.2021.01.017. Epub 2021 Jan 24. No abstract available.
Wittkopf PG, Larsen DB, Graven-Nielsen T. Protocols for inducing homeostatic plasticity reflected in the corticospinal excitability in healthy human participants: A systematic review and meta-analysis. Eur J Neurosci. 2021 Aug;54(4):5444-5461. doi: 10.1111/ejn.15389. Epub 2021 Jul 30.
Wittkopf PG, Boye Larsen D, Gregoret L, Graven-Nielsen T. Disrupted Cortical Homeostatic Plasticity Due to Prolonged Capsaicin-induced Pain. Neuroscience. 2023 Nov 21;533:1-9. doi: 10.1016/j.neuroscience.2023.09.011. Epub 2023 Sep 27.
Thapa T, Graven-Nielsen T, Schabrun SM. Aberrant plasticity in musculoskeletal pain: a failure of homeostatic control? Exp Brain Res. 2021 Apr;239(4):1317-1326. doi: 10.1007/s00221-021-06062-3. Epub 2021 Feb 26.
Thapa T, Graven-Nielsen T, Chipchase LS, Schabrun SM. Disruption of cortical synaptic homeostasis in individuals with chronic low back pain. Clin Neurophysiol. 2018 May;129(5):1090-1096. doi: 10.1016/j.clinph.2018.01.060. Epub 2018 Feb 9.
Lejeune N, Petrossova E, Frahm KS, Mouraux A. High-speed heating of the skin using a contact thermode elicits brain responses comparable to CO2 laser-evoked potentials. Clin Neurophysiol. 2023 Feb;146:1-9. doi: 10.1016/j.clinph.2022.11.008. Epub 2022 Nov 24.
Lenoir C, Algoet M, Mouraux A. Deep continuous theta burst stimulation of the operculo-insular cortex selectively affects Adelta-fibre heat pain. J Physiol. 2018 Oct;596(19):4767-4787. doi: 10.1113/JP276359. Epub 2018 Sep 4.
Other Identifiers
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CHEPS-DMZ-CNAP
Identifier Type: -
Identifier Source: org_study_id
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