VIRTUAL WALKING and TRANSCRANIAL DIRECT CURRENT STIMULATION for CHRONIC NEUROPATHIC PAIN DUE to SPINAL CORD INJURY

NCT ID: NCT06710808

Last Updated: 2024-11-29

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

4 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-12

Study Completion Date

2025-04-01

Brief Summary

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The goal of this feasibility study is to assess the feasibility of the combined treatment intervention "virtual walking (VW) and transcranial direct current stimulation (tDCS)" of neuropathic pain in patients with spinal cord injury. The main question aims to answer:

• To assess the feasibility of combining VW and tDCS for longer-term use from the patients' point of view.

Participants will:

Receive a two week intervention in the Swiss Paraplegic Centre in Nottwil, where the participants undergo VW and tDCS for ten sessions, each lasting around 20 minutes.

The participants keep a diary and a pain drawing of their symptoms and will fill out some questionnaires about their impression of feasibility, the pain intensity, chronicity, the impression of change, depression, anxiety, stress and adverse events. At the beginning and end of the study the participants will be interviewed about their expectations, hopes and the feasibility of the procedures from a participants point of view.

Detailed Description

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Conditions

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Spinal Cord Injury Chronic Neuropathic Pain

Keywords

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Neuropathic pain Chronic neuropathic pain spinal cord injury virtual walking transcranial direct current stimulation tDCS

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Virtual walking and transcranial direct current stimulation of 2 milliampere for 20 minutes

Group Type EXPERIMENTAL

Virtual walking and transcranial direct current stimulation

Intervention Type OTHER

Participants will receive VW-therapy combined with tDCS. The intervention is adapted from Soler et al. 2010 and consists of 10 sessions over 2 weeks, each session lasting around 20 minutes.

For the virtual walking the participant sits on a modified wheelchair, which is positioned at a distance of two meters from the screen. The setting provides an illusion of a third person perspective and the participant can see himself/herself walk through a forest ambience.

The tDCS session is according the same protocol from Soler et al., 2010. Hereby, the device from Starstim, Neuroelectrics will be used, which is equipped with a neoprene cap containing electrodes. The anodes will be placed over C3 or C4 (EEG 10/20 system) to target the motor cortex (M1) contralateral to the painful side and the cathodes will be placed over the contralateral supraorbital area. Symmetric pain participants receive stimulation on the dominant hemisphere. The tDCS applies a constant current of 2 mA over 20 minutes.

Interventions

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Virtual walking and transcranial direct current stimulation

Participants will receive VW-therapy combined with tDCS. The intervention is adapted from Soler et al. 2010 and consists of 10 sessions over 2 weeks, each session lasting around 20 minutes.

For the virtual walking the participant sits on a modified wheelchair, which is positioned at a distance of two meters from the screen. The setting provides an illusion of a third person perspective and the participant can see himself/herself walk through a forest ambience.

The tDCS session is according the same protocol from Soler et al., 2010. Hereby, the device from Starstim, Neuroelectrics will be used, which is equipped with a neoprene cap containing electrodes. The anodes will be placed over C3 or C4 (EEG 10/20 system) to target the motor cortex (M1) contralateral to the painful side and the cathodes will be placed over the contralateral supraorbital area. Symmetric pain participants receive stimulation on the dominant hemisphere. The tDCS applies a constant current of 2 mA over 20 minutes.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18y, ≤ 75y
* traumatic SCI (\> 6 month after SCI) with a SCI severity grade AIS A, B, C or D
* At or below level spinal cord injury neuropathic pain on trunk or lower extremities according to the ISCIP classification (Bryce et al., 2012) of at least 4/10 intensity on a NRS (Langford et al., 2023) with in the last 7 days (WiderströmNoga et al., 2023)
* Good communication in German to understand the instructions, assessments and to fill in questionnaires
* Adequate siting balance
* Ability to draw with a pencil
* Ability to swing arms

Exclusion Criteria

* severe psychiatric disorder requiring psychiatric hospitalisation or mental disease that could interfere with their ability to participate
* Previous brain surgery
* Metal implants in the skull or brain, including cochlear implants, intracranial electrodes or a pacemaker (Datta et al., 2010)
* Drugs that affect cortical excitability (McLaren et al., 2018): Alcohol, Amphetamines, Theophylline (asthma treatment), Chlorpromazine, Clozapine, Amitriptyline, Doxepine, Imipramine, Maprotiline, Nortriptyline, Foscarnet, Ganciclovir, Ritonavir, Amphetamines, Cocaine, Gamma-hydroxybutyrate (GHB), Ketamine, MDMA, ecstasy Phencyclidine
* Previous adverse effects of stimulation with tDCS
* A scalp or skin condition (e.g. psoriasis or eczema)
* History of epilepsy or seizure
* Pregnancy (anamnestic)
* Inability to give consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Swiss Paraplegic Research, Nottwil

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Swiss Paraplegic Centre

Nottwil, , Switzerland

Site Status RECRUITING

Countries

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Switzerland

Central Contacts

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KD Dr. med. Gunther Landmann, MSc

Role: CONTACT

Phone: +41 41 939 49 00

Email: [email protected]

Facility Contacts

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KD Dr. med. Gunther Landmann, MSc

Role: primary

Other Identifiers

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2024-12

Identifier Type: -

Identifier Source: org_study_id