NCT03217929

Brief Summary

Background: Obesity is one of the most important diseases around the globe; with a continuous increase and public health concern. Current treatments present some limitations. Craving is a symptom usually noticeable and has been described as a "strong desire or urge to use", especially with foods. The vagus nerve and its relations to the neurocircuitry of the reward system play essential roles in food intake regulation and this can be done transcutaneously trough the auricular branch of the vagus nerve (taVNS). Based on the neurobiology of food craving and on the initial data on taVNS demonstrating safety and efficacy in open-label and randomized sham controlled trials, the investigators propose the first randomized, sham controlled, triple-blind trial on taVNS for food craving in obesity. Methods: This will be a two-arm, triple-blinded, randomized controlled trial with 54 subjects with food craving assigned to either: 1) a 10-session treatment protocol of real taVNS, or 2) a 10-session treatment protocol of sham taVNS, besides qualitative electroencephalogram (qEEG) and heart rate variability (HRV). Participants will be evaluated for primary outcome measures (Food Craving Questionnaire - State \[FCQ-S\] and Food Craving Questionnaire - Trait \[FCQ-T\]) before and after intervention, with a follow-up visit of 30 days after the end of treatment. A comparison between sham and active groups will be performed in three occasions \[baseline (T1), at the end of the stimulation protocol (T2) and 30 days after the last day of stimulation (T3)\]. Discussion: Given the epidemiological situation and economic and social burdens, the possibility of modulating the reward system neurocircuitry trough the vagus nerve with an easy-to-use, low-cost, safe and potential at-home use could represent a breakthrough in treating obesity. The investigators hypothesized that food craving in obese individuals would decrease at least 50%, as well as their intake of high fat, high sugar and processed food, commonly described as palatable foods. Beyond that, the investigators expect that these individuals would improve anxiety symptoms.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
54

participants targeted

Target at P25-P50 for not_applicable obesity

Timeline
Completed

Started Oct 2017

Geographic Reach
1 country

1 active site

Status
unknown

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

First Submitted

Initial submission to the registry

July 11, 2017

Completed
3 days until next milestone

First Posted

Study publicly available on registry

July 14, 2017

Completed
3 months until next milestone

Study Start

First participant enrolled

October 1, 2017

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2018

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2019

Completed
Last Updated

July 14, 2017

Status Verified

July 1, 2017

Enrollment Period

1 year

First QC Date

July 11, 2017

Last Update Submit

July 12, 2017

Conditions

Keywords

vagus nerveobesitycravingfood

Outcome Measures

Primary Outcomes (1)

  • Reduction of 40% of food craving symptoms

    Changes in food craving will be evaluated by the Brazilian version of the FCQ-S and FCQ-T. A comparison between sham and active groups will be performed in three occasions.

    Baseline, at the end of the stimulation protocol (10 days after) and 30 days after the last day of stimulation.

Secondary Outcomes (3)

  • Decrease of 10% of BMI and hip/waist ratio

    Baseline, at the end of the stimulation protocol (10 days after) and 30 days after the last day of stimulation.

  • Improve metabolic profile.

    Baseline, at the end of the stimulation protocol (10 days after) and 30 days after the last day of stimulation.

  • Improve anxiety symptoms evaluated by the Inventory for Depressive Symptoms (Self-Report version).

    Baseline, at the end of the stimulation protocol (10 days after) and 30 days after the last day of stimulation.

Study Arms (2)

Active-taVNS

ACTIVE COMPARATOR
Device: Active-taVNS

Sham-taVNS

SHAM COMPARATOR
Device: Sham-taVNS

Interventions

Stimulation will be performed using the Neurodyn II (Ibramed) equipment approved by the national regulatory agency (ANVISA). The following parameters will be used: 120 Hz (hertz) of frequency, 250 μs of pulse duration and 12 milliamperes of intensity for a continuous stimulation for 30 minutes. This intensity corresponds to a non-painful mild paresthesia without muscle contraction previously described and evaluated. The 25 cm² (centimeters) electrodes will be positioned over the retroauricular area. A total of 10 sessions (one session per day during 10 week-days) will be performed. Every session will be followed by an interview with a trained psychiatrist to evaluate possible adverse effects and guarantee safety issues regarding the study itself.

Active-taVNS

Regarding sham protocol, the device will be turned off after 60 seconds of stimulation without the knowledge of the patient. After this initial period, the referred paresthesia seems to diminish due to nerve accommodation.

Sham-taVNS

Eligibility Criteria

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

You may qualify if:

  • Body mass index (BMI)\>29
  • Age between 18 and 55 years old
  • Food Craving Questionnaire-State and Trait (FCQ-S and FCQ-T)\>108
  • Agreement to participate and sign the informed consent term before any procedure is conducted.

You may not qualify if:

  • History of head injury or epilepsy
  • Body metallic implants and pacemaker
  • Current use or in the previous six months of psychotropic or anorexigenic medications, recreational drugs and/or participation in weight-loss programs
  • Pregnancy or breastfeeding
  • Indication of hospitalization
  • Substance dependence
  • Psychiatric disorder, except for anxiety disorders
  • Personality disorders
  • Suicidal ideation
  • Non-controlled clinical comorbidities.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Federal University of São Paulo

São Paulo, 04038-020, Brazil

Location

MeSH Terms

Conditions

Obesity

Condition Hierarchy (Ancestors)

OverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • Ruth B Grigolon, Master

    Federal University of São Paulo

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Ruth B Grigolon, Master

CONTACT

Alisson P Trevizol, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Master

Study Record Dates

First Submitted

July 11, 2017

First Posted

July 14, 2017

Study Start

October 1, 2017

Primary Completion

October 1, 2018

Study Completion

October 1, 2019

Last Updated

July 14, 2017

Record last verified: 2017-07

Locations