NCT04665492

Brief Summary

Spinal cord injury (SCI), induced by damage to the spinal cord, can cause life-altering levels of disability including the development of chronic pain. Central Neuropathic Pain (CNP) typically develops within months after injury in 40-50% of SCI patients, affecting everyday activity, sleep and mood. There is no cure for CNP, it can be very difficult to treat and is often refractory to any pharmacological treatments. In a previous study (study no. 14/WS/1029) the principle investigators showed that the likelihood of CNP developing can be predicted by defining characteristics of brain waves that are related to pain. We will use electroencephalograph (EEG) to measure brain activity in people early after SCI, before they develop pain, knowing that about half will develop pain within a year. We aim to recruit 80 participants, aged 18-80; 40 with subacute spinal injury (level C3-T12) and no symptoms of CNP; 20 with symptoms of CNP and 20 able-bodied participants. Completeness of injury is irrelevant. Patients will be recruited by clinical consultants within national spinal units in Glasgow and Stoke Mandeville. Patients will undergo two EEG recording sessions in which they will imagine movements while we record EEG. Sessions will also involve basic sensory testing and completion of questionnaires. Able-bodied participants will be recruited by the Philosophy Doctor (PhD) candidate at the University of Glasgow and undergo only one EEG session (identical to SCI patients). The primary aim of this study is to use early EEG markers of CNP to optimise and validate an existing computer program based on machine learning to enable more accurate prediction of pain in newly injured patients with the hope of aiding future treatments. Secondary aims include characterising EEG features which might describe different phases in patients' development of CNP and exploring possible differences between pain at/below the level of SCI based on EEG markers.

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
80

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Jan 2021

Typical duration for all trials

Geographic Reach
1 country

2 active sites

Status
unknown

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

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 16, 2020

Completed
25 days until next milestone

First Posted

Study publicly available on registry

December 11, 2020

Completed
1 month until next milestone

Study Start

First participant enrolled

January 15, 2021

Completed
1.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2022

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2023

Completed
Last Updated

December 16, 2020

Status Verified

November 1, 2020

Enrollment Period

1.8 years

First QC Date

November 16, 2020

Last Update Submit

December 14, 2020

Conditions

Keywords

Spinal Cord InjuryCentral Neuropathic PainEEGPain markers

Outcome Measures

Primary Outcomes (2)

  • EEG based classifier of pain

    Create a software application that can classifify between people with SCI and healthy people and people with SCI with and without pain based on EEG markers

    All groups EEG recording upon recruitment

  • Changes in EEG

    Difference between baseline EEG and EEG recorded six months later

    EEG recording upon recruitment and EEG recording six month later in all groups of people with SCI

Secondary Outcomes (3)

  • EEG markers of different phased of SCI

    Fist EEG recording upon recruitment, second six month later

  • EEG markers of at level and below level pain

    Fist EEG recording upon recruitment, second six month later

  • Correlation between sensory and neurological test and questionnaires

    Fist EEG recording, sensory test and questionnaires uppon recruitment, second six month later

Study Arms (3)

SCI with CNP

People with subacute spinal cord injury and no chronic pain

Diagnostic Test: EEG recording 1Diagnostic Test: EEG recording 2Diagnostic Test: Sensory TestDiagnostic Test: Brief Pain Inventory 1Diagnostic Test: Multidimensional health locus of controlDiagnostic Test: Sensory test thermalDiagnostic Test: Neuropathic pain symptomsDiagnostic Test: McGill pain questionnaireDiagnostic Test: Pain Catastrophising Scale

SCI no CNP

People with subacute spinal cord injury with central neuropathic pain

Diagnostic Test: EEG recording 1Diagnostic Test: EEG recording 2Diagnostic Test: Sensory TestDiagnostic Test: Brief Pain Inventory 1Diagnostic Test: Sensory test thermalDiagnostic Test: Neuropathic pain symptoms

Able bodied

Able bodied people with no chronic pain

Diagnostic Test: EEG recording 1Diagnostic Test: Brief Pain Inventory 1

Interventions

EEG recording 1DIAGNOSTIC_TEST

Multichannel EEG recording in eyes opened and eyes closed relaxed state and during imagined movement (all one experimental session). EEG device "usbamp" (company "Guger Technologies", Austria) will be used.

Able bodiedSCI no CNPSCI with CNP
EEG recording 2DIAGNOSTIC_TEST

Multichannel EEG recording in eyes opened and eyes closed relaxed state and during imagined movement (all one experimental session). This intervention will take place six month after EEG recording 1. EEG device "usbamp" (company "Guger Technologies", Austria) will be used.

SCI no CNPSCI with CNP
Sensory TestDIAGNOSTIC_TEST

Test for mechanical sensations of the feet and shins of both legs as well as on the trapezoidal muscle on both sides. Semmes-Weinstein Monofilaments will be used

SCI no CNPSCI with CNP
Brief Pain Inventory 1DIAGNOSTIC_TEST

This questionnaire that ask about any acute or chronic pain

Able bodiedSCI no CNPSCI with CNP

Questionnaire that test personal belief about control of one's own health

SCI with CNP
Sensory test thermalDIAGNOSTIC_TEST

Test of thermal sensations (thermal roller) of the feet and shins of both legs as well as on the trapezoidal muscle on both sides. A "Somedic SenseLab Rolltemp" device will be used

SCI no CNPSCI with CNP

Questionnaire that test for neuropathic pain symptoms

SCI no CNPSCI with CNP

Questionnaire assess three separate components of experiencing pain; the sensory intensity, the emotional impact and the cognitive evaluation of pain.

SCI with CNP

Questionnaire use to identify individual pain experience.

SCI with CNP

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Able bodied people and people with subacute spinal cord injury

You may qualify if:

  • Age between 18-80
  • Subacute spinal cord injury (within 6 months post injury)
  • Level C3-T12
  • ASIA A, B, C or D
  • Normal or corrected to normal vision
  • No allodynia or hyperalgesia
  • Age between 18-80
  • Subacute spinal cord injury (within 6 months of injury)
  • Level C3-T12
  • ASIA A, B, C or D
  • Normal or corrected to normal vision
  • Presence of allodynia or hyperalgesia
  • Diagnosed CNP related to SCI equal or larger than 4 on visual numerical scale (VNS)
  • Age 18-80
  • No self-reported neurological conditions
  • +3 more criteria

You may not qualify if:

  • Inability to understand the task
  • Inability to sit for at least 2 hours (duration of EEG assessment)
  • Invasive 24/7 ventilation
  • Previously confirmed brain injury, (peripheral nerve injury and brachial plexus injury)
  • Other self-reported neurological condition that would affect EEG recording
  • Presence/history of any other chronic or acute pain (larger or equal to 3 on the VNS)
  • Pressure sores or any other condition that might prevent sitting for 2 hours
  • Halos or neck support that prevent EEG recording
  • Infections of the skin or communicable diseases (e.g. hospital bugs)
  • Concurrent acute medical problems (e.g. infections)
  • Infection control issues i.e. the need for patient isolation
  • Do not understand English
  • Unable to give informed consent
  • Presence of chronic or acute pain equal to or larger than 3 on VNS
  • Any self-reported neurological conditions
  • +1 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Stoke Mandevill Hospital, National Spinal Injuries Unit

Stoke Mandeville, Buckinghamshire, HP218AL, United Kingdom

Location

Queen Elizabeth University Hospital, Queen Elizabeth National Spinal Injurie Unit

Glasgow, G514TF, United Kingdom

Location

MeSH Terms

Conditions

Spinal Cord Injuries

Interventions

Pain Measurement

Condition Hierarchy (Ancestors)

Spinal Cord DiseasesCentral Nervous System DiseasesNervous System DiseasesTrauma, Nervous SystemWounds and Injuries

Intervention Hierarchy (Ancestors)

Neurologic ExaminationPhysical ExaminationDiagnostic Techniques and ProceduresDiagnosis

Study Officials

  • Aleksandra Vuckovic

    University of Glasgow

    STUDY DIRECTOR

Central Study Contacts

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 16, 2020

First Posted

December 11, 2020

Study Start

January 15, 2021

Primary Completion

November 1, 2022

Study Completion

April 1, 2023

Last Updated

December 16, 2020

Record last verified: 2020-11

Locations