NCT01820923

Brief Summary

The aim of this study is to determine whether transcranial brain stimulations, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), are effective in terms of EEG coherence and clinical changes in patients in vegetative and minimally conscious state.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
40

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Jul 2011

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

July 1, 2011

Completed
1.7 years until next milestone

First Submitted

Initial submission to the registry

March 14, 2013

Completed
15 days until next milestone

First Posted

Study publicly available on registry

March 29, 2013

Completed
1.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2014

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2014

Completed
Last Updated

March 25, 2015

Status Verified

March 1, 2015

Enrollment Period

3.4 years

First QC Date

March 14, 2013

Last Update Submit

March 24, 2015

Conditions

Outcome Measures

Primary Outcomes (1)

  • EEG coherence analysis

    EEG will be filtered between 0.5 and 30Hz by elliptic filters. Fast Fourier Transformation will be performed on 2 sec-epochs. For each stimulation site, coherence values will be estimated within four frequency bands: Delta (0.5-3.5 Hz), Theta (4-7.5 Hz), Alpha (8-12.5 Hz), and Beta (13-30 Hz). Each coherence map will be proportionally thresholded, preserving 50% of the strongest coherence values, to produce a weighted adjacency matrix. The estimated functional connectivity patterns will be characterized by means of two global network metrics derived from graph theory: modularity and global efficiency. Modularity measures how the network is organized into modules with high level clustering. Global efficiency measures how efficient the network is in exchanging information at the global level.

    Change from baseline EEG coherence at the end of brain stimulation (two weeks)

Secondary Outcomes (1)

  • Disability Rating Scale

    Change from baseline DRS scale at the end of brain stimulation (two weeks)

Other Outcomes (1)

  • Western Neuro Sensory Stimulation Profile (WNSSP)

    Change from baseline WNSSP scale at the end of brain stimulation (two weeks)

Study Arms (1)

Brain stimulation

EXPERIMENTAL

Brain stimulation will consist of 4 types of intervention: * real transcranial direct current stimulation (two weeks, five days a week) * a week of wash-out * Sham transcranial direct current stimulation (two weeks, five days a week) * two weeks of wash-out * real repetitive transcranial magnetic stimulation (two weeks, four days a week) * a week of wash-out * Sham repetitive transcranial magnetic stimulation (two weeks, three days a week) Stimulations will be counterbalanced between patients.

Device: Transcranial direct current stimulation (tDCS)Device: Repetitive Transcranial Magnetic Stimulation (rTMS)Device: Transcranial Direct Current Stimulation (SHAM)Device: Repetitive Transcranial Magnetic Stimulation (SHAM)

Interventions

2 mA of intensity, 20 minutes of stimulation over the left fronto-temporal prefrontal cortex.

Brain stimulation

Frequency of stimulation: 10Hz. Interstimulus interval: 1 min. Number of stimuli per session: 300. Number of sessions per week: 4 Total number of stimuli: 1.200

Brain stimulation

The electrodes of stimulation will be applied in the left fronto-temporal prefrontal cortex, but the device will be turned off.

Brain stimulation

The coil will be applied on the left fronto-temporal prefrontal cortex, but the device will be turned off.

Brain stimulation

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Diagnosis of vegetative state od minimally conscious state defined by the Disability Rating Scale with a score between 17 and 29.
  • Age between 18 and 65 years.
  • Time from the lesion: more than 4 months.
  • Stable clinical condition.
  • written consent fron the legal administrator of the patient.

You may not qualify if:

  • Presence of epileptiform activity on EEG.
  • Previous history of epilepsy.
  • Extensive hemorrhage or ischemia.
  • Metallic clips or intracranial implants.
  • Pacemaker e Baclofen infusion.
  • Presence of drugs influencing arousal or awareness.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

IRCCS San Camillo Foundation

Venice, Venice, 30126, Italy

Location

Related Publications (2)

  • Giacino J, Fins JJ, Machado A, Schiff ND. Central thalamic deep brain stimulation to promote recovery from chronic posttraumatic minimally conscious state: challenges and opportunities. Neuromodulation. 2012 Jul;15(4):339-49. doi: 10.1111/j.1525-1403.2012.00458.x. Epub 2012 May 24.

    PMID: 22624587BACKGROUND
  • Piccione F, Cavinato M, Manganotti P, Formaggio E, Storti SF, Battistin L, Cagnin A, Tonin P, Dam M. Behavioral and neurophysiological effects of repetitive transcranial magnetic stimulation on the minimally conscious state: a case study. Neurorehabil Neural Repair. 2011 Jan;25(1):98-102. doi: 10.1177/1545968310369802. Epub 2010 Jul 20.

MeSH Terms

Conditions

Persistent Vegetative State

Interventions

Transcranial Direct Current StimulationTranscranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

Brain Damage, ChronicBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesUnconsciousnessConsciousness DisordersNeurobehavioral ManifestationsNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Electric Stimulation TherapyTherapeuticsConvulsive TherapyPsychiatric Somatic TherapiesBehavioral Disciplines and ActivitiesElectroshockPsychological TechniquesMagnetic Field Therapy

Study Officials

  • Francesco Piccione, MD

    San Camillo Foundation

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
PhD

Study Record Dates

First Submitted

March 14, 2013

First Posted

March 29, 2013

Study Start

July 1, 2011

Primary Completion

December 1, 2014

Study Completion

December 1, 2014

Last Updated

March 25, 2015

Record last verified: 2015-03

Locations