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Trial registered on ANZCTR
Registration number
ACTRN12609000071224
Ethics application status
Approved
Date submitted
15/01/2009
Date registered
28/01/2009
Date last updated
14/03/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Brain stimulation to reduce pain following spinal cord injury
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Scientific title
Treatment of neuropathic pain following spinal cord injury using transcranial direct current stimulation
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Secondary ID [1]
252916
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Neuropathic spinal cord injury pain
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Condition category
Condition code
Neurological
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0
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Other neurological disorders
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Anaesthesiology
4404
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0
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Pain management
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Injuries and Accidents
4405
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0
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Other injuries and accidents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Anodal and cathodal transcranial direct current stimulation (tDCS) of primary motor cortex using a saline-soaked pair of surface sponge electrodes at constant current intensity of 2 milliamps for 20 minutes administered daily during 2 x 5 day periods separated by 4 weeks without treatment. The site of electrode placement will be determined using a standard Electroencephalography (EEG) head cap used to position EEG recording electrodes. The anode electrode will be placed over C3 or C4 (using EEG 10/20 system) and the cathode electrode over the contralateral supraorbital area (i.e. above the opposite eye socket).
Magnetic resonance imaging (MRI) pre- and post-treatment to investigate brain alterations associated with reduction in pain intensity using tDCS. Functional MRI (fMRI) and structural imaging performed prior to and immediately following each treatment week and at 10 weeks and 6 months follow-up after study commencement.
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Intervention code [1]
3911
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Treatment: Devices
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Comparator / control treatment
Control (sham) stimulation in which transcranial direct current stimulation will be delivered for 30 seconds using surface sponge electrodes placed in the same positions as for active stimulation and then discontinued for the remainder of the 20 minute treatment session. All subjects will receive both real and sham stimulation, each comprising 5 daily sessions with a "washout" period of 4 weeks between them (i.e. all subjects will receive the active treatment in one 5 day treatment period and the placebo treatment in the other 5 day treatment period).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Pain severity as assessed by administration of the International Spinal Cord Injury Basic Pain Dataset and/or Neuropathic Pain Scale
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Assessment method [1]
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Timepoint [1]
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At baseline, prior to and after each period of intervention, days 1-5 of each treatment week and at 10 weeks and 6 months after intervention commencement
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Secondary outcome [1]
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Functional independence as assessed by administration of the Spinal Cord Independence Measure (SCIM III)
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Assessment method [1]
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Timepoint [1]
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At baseline, prior to and after each period of intervention and at 10 weeks and 6 months after intervention commencement
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Secondary outcome [2]
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Mood as assessed by administration of the Beck Depression Inventory
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Assessment method [2]
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Timepoint [2]
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At baseline, prior to and after each period of intervention and at 10 weeks and 6 months after intervention commencement
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Secondary outcome [3]
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Patient global impression of change (PGIC)
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Assessment method [3]
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Timepoint [3]
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At baseline, prior to and after each period of intervention and at 10 weeks and 6 months after intervention commencement
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Secondary outcome [4]
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Measurements of brain changes using MRI techniques
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Assessment method [4]
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Timepoint [4]
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At baseline, prior to and after each period of intervention and at 10 weeks and 6 months after intervention commencement
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Eligibility
Key inclusion criteria
Complete thoracic spinal cord injury (American Spinal Injury Association (ASIA) Impairment Scale (AIS) A)
6 or more months following injury
Medically stable
Persistent neuropathic pain present for more than 6 months which is moderate to severe in intensity (greater than or equal to 4/10 on a numerical rating scale)
Must give informed consent to participate in the study
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Intellectual or mental impairment preventing full understanding of the risks and benefits of participating and/or obtaining informed consent
Subjects who have metal objects in their body, anxiety disorders, such as claustrophobia, panic attacks or any psychiatric disorder may be excluded
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
29/07/2010
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Actual
2/07/2010
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Date of last participant enrolment
Anticipated
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Actual
18/06/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
25
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NSW Office for Science and Medical Research
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Address [1]
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GPO Box 5477
Sydney NSW 2001
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Prof Philip Siddall
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Address
Pain Management Research Institute
Level 10 Main Block
Royal North Shore Hospital
Pacific Hwy
St Leonards NSW 2065
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Paul Wrigley
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Address [1]
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Pain Management Research Institute
Level 13 Kolling Building
Royal North Shore Hospital
Pacific Hwy
St Leonards NSW 2065
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Country [1]
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Sylvia Gustin
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Address [1]
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Pain Management Research Institute
Royal North Shore Hospital
Pacific Hwy
St Leonards NSW 2065
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern Sydney Central Coast Health Human Research Ethics Committee
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Ethics committee address [1]
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Research Office Level 2 Building 51 Royal North Shore Hospital Pacific Hwy St Leonards NSW 2065
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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16/10/2008
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Approval date [1]
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18/03/2009
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Ethics approval number [1]
6424
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0811-241M(CTN-dev)
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Summary
Brief summary
Pain, particularly neuropathic pain, is a common and debilitating consequence of spinal cord injury. Despite the high prevalence and severity of pain, there are currently no available treatments that provide consistent or satisfactory relief. Transcranial direct current stimulation (tDCS) is a safe non-invasive brain stimulation technique that may be helpful in reducing pain following spinal cord injury. This study is aimed at evaluating the effectiveness of tDCS as a treatment for spinal cord injury neuropathic pain. Subjects will undergo 10 tDCS treatment sessions over a period of 5 weeks as well as magnetic resonance imaging (MRI) scans prior to and immediately following each treatment week, and at 10 weeks and 6 months after study commencement. The technique is not painful and no serious side effects have been reported. Our hypothesis is that tDCS will provide relief of neuropathic pain following spinal cord injury. If proven effective, tDCS may provide a much needed non-invasive alternative treatment for patients with persistent spinal cord injury neuropathic pain.
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Trial website
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Trial related presentations / publications
Wrigley PJ, Gustin SM, McIndoe LN, Chakiath RJ, Henderson LA, Siddall PJ. Longstanding neuropathic pain after spinal cord injury is refractory to transcranial direct current stimulation: a randomized controlled trial. Pain. 2013 Oct;154(10):2178-84.
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Public notes
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Contacts
Principal investigator
Name
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Prof Philip Siddall
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Address
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Pain Management Service, Hammondcare
Greenwich Hospital, River Road, Greenwich, NSW, 2065, Australia
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Country
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Australia
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Phone
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+ 61 2 8788 3941
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Paul Wrigley
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Address
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Pain Management Research Institute
Level 13 Kolling Building
Royal North Shore Hospital
Pacific Hwy
St Leonards NSW 2065
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Country
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Australia
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Phone
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+61 2 99264958
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Prof Philip Siddall
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Address
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Pain Management Research Institute
Level 10 Main Block
Royal North Shore Hospital
Pacific Hwy
St Leonards NSW 2065
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Country
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Australia
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Phone
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+61 2 99266387
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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