Analyzing the Brain Alterations of Acupuncture on Patients With CP/CPPS Evaluated by fMRI

NCT05075551 | Unknown

• 1 other identifier: 681328
• Study Type: interventional
• Target: 500
• Locations: 1 country
• Sites: 1

Brief Summary

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is one of the most common diseases in urology, but its pathogenesis remains unclear and the effective therapy lacks. As a kind of chronic pain which the patients suffered for more than 3 months, CP/CPPS could be alleviated by acupuncture. Functional magnetic resonance imaging (fMRI) and higher magnetic field strengths could enable scientists to investigate the brain accurately and non-invasively during every stage of chronic pain.To avoid placebo effect, sham acupuncture would be also enrolled.Herein, by the utilization of fMRI in resting-state, we investigated the influence on patients' brain alterations after the patients accepted the treatment of acupuncture.

Conditions

Chronic Prostatitis With Chronic Pelvic Pain Syndrome

Keywords

Chronic Prostatitis/Chronic Pelvic Pain Syndrome; Functional Magnetic Resonance Imaging; Acupuncture

Outcome Measures

Primary Outcomes (1)

• The change in the NIH-CPSI total score at the end of week 12 and week 36

  The responder is defined as who has a decline of 6 or more than 6-point from baseline measured by using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) , compared with the baseline in week 0.It is because a decline of at least 6 points in NIH-CPSI is acknowledged as the minimal clinically important difference. The NIH-CPSI is a self-assessment form with nine items, which the main components encompass pain with 4 items focused on location, severity and frequency, urinary function embracing one irritative item and one obstructive item, and quality of life impact with 3 items about the effect of symptoms on daily activities. The NIH-CPSI provides a systematized and unanimously accepted outcome measuring tool, and it is widely used in clinical trials, along with in the evidence-based evaluation of treatment effects.

  week 0, week 12 and week 36

Secondary Outcomes (9)

• The alterations in brain of patients with CP/CPPS measured by fMRI when finishing the whole treatment

  week 12

• The alterations in brain of patients with CP/CPPS measured by fMRI in the following-up (24weeks after treatment)

  week 36

• the change from baseline in NIH-CPSI subscales

  week 0, week 12, week 36

• the change from baseline in the International Prostate Symptom Score (IPSS)

  week 0, week 12, week 36

• the change from baseline in the Visual Analogue Scale (VAS)

  week 0, week 12, week 36

Study Arms (2)

Acupuncture

EXPERIMENTAL

Before participants accept the treatment, they are acquired to finish the clinical scales (including NIH-CPSI scale, HADS, VAS, SSRS, SES, IPSS and QoL) and then get the fMRI scan. Hwato brand disposable acupuncture needles will be used. Sanyinjiao (SP6), Zhibian (BL54), Shenshu (BL23), and Huiyang (BL35) are selected as acupoints. The course of treatment is 2 times a week in three months (totally 24 times). At the ending of the treatment, all the volunteers will be asked to finish the clinical scales and get the fMRI scan again. As the step of following up, all the patients will be asked to finish the clinical scales and get the fMRI scan again to evaluate the efficacy of avoiding the recurrence of acupuncture.

Device: Acupuncture; Other: fMRI scan

Sham Acupuncture

SHAM COMPARATOR

In the sham acupuncture group, these volunteers will receive relatively shallow needling at bilateral sham SP6, BL54, BL23, and BL35. This treatment gets involved in the same duration and frequency of sessions, but the treatment was delivered superficially at non-acupuncture points 10 mm to the lateral of corresponding acupuncture and not above a meridian line (10mm to SP6, BL54, BL23 and BL35). The Hwato brand disposable acupuncture needles will be inserted with a depth of 2-3 mm without any manipulation.The procedure of finishing scales and get fMRI scanning will be the same as the group of acupuncture.

Device: Sham acupuncture; Other: fMRI scan

Interventions

Acupuncture DEVICE

Hwato brand disposable acupuncture needles (size 0.30 × 75mm; size 0.30 × 40mm) will be used.SP6 is on the tibial aspect of the leg, posterior to the medial border of the tibia, 3 cun superior to the prominence of the medial malleolus; BL23 is in the sacral region, in the second posterior sacral foramen; BL54 is in the fourth posterior sacral foramen, 3 cun beside the median sacral crest; BL35 is in the buttock region, 0.5 cun lateral to the extremity of the coccyx.

Acupuncture

Sham acupuncture DEVICE

Hwato brand disposable acupuncture needles (size 0.30 × 75mm; size 0.30 × 40mm) will be used.These volunteers will receive relatively shallow needling at bilateral sham SP6, BL54, BL23 and BL35. This treatment gets involved in the same duration and frequency of sessions, but the treatment was delivered superficially at non-acupuncture points 10 mm to the lateral of corresponding acupuncture and not above a meridian line (10mm to SP6, BL54, BL23 and BL35).The same equipment of fMRI scanner will be used.

Sham Acupuncture

fMRI scan OTHER

Both two group will get fMRI scan week 0 (before treatment), week 12 (after treatment) and week 36 (following up). The resting-state fMRI data will be obtained by using a 3.0T GE MR 750 MRI scanner with an eight-channel phase array head coil at the Huashan Hospital, Shanghai. The high resolution T1-weighted magnetic resonance images will be collected by a three-dimensional fast spoiled gradient-echo dual-echo sequence \[repetition time (TR) = 8100 ms; echo time (TE) = 3.1 ms; FA = 8 deg; matrix=256 × 256; field of view (FOV)=25.6× 25.6 cm2; slice thickness=1 mm; no gap and 156 slices\]. The whole resting state fMRI data will be acquired by using a gradient-recalled echo-planar imaging pulse sequence (TR/TE = 2,000/30 ms; FA = 90°; acquisition matrix = 64×64; FOV = 22×22 cm2; slice thickness= 4 mm; 43 slices and total 240 time points; no gap).

Acupuncture; Sham Acupuncture

Eligibility Criteria

• Age: 20 Years - 50 Years
• Gender Eligibility Details: To reduce the potential impact of senile brain atrophy, aged from 20 to 50 years volunteers were required.
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• he chief complaint is long-term recurrent pain or discomfort of lumbosacral and perianal distension in the lower abdomen of the external perineum genital area and the superior pubic area (more than 3 months).
• Bacterial prostatitis will be eliminated by routine culture of prostatic fluid and urine culture before and after prostatic massage.
• Urinary tract infection will be ruled out by routine urinalysis and sediment examination.
• (2)Total score of NIH-CPSI ≥ 15.

You may not qualify if:

• The participants would be excluded if they got any acute or chronic infectious disease, other chronic pain diseases, internal organic diseases, history of malignant tumors, and chronic diseases that might contribute to peripheral nerve injury like diabetes mellitus and hypertension.
• Prostate changes will be observed by prostate ultrasound and other urogenital and pelvic space-occupying lesions will be excluded.
• Contraindications of fMRI scan like claustrophobia and denture implantation status are also considered.

Sponsors & Collaborators

• Shanghai University of Traditional Chinese Medicine: lead
• Huashan Hospital: collaborator

Study Sites (1)

Department of Acupuncture, LongHua Hospital, Shanghai University of Traditional Chinese Medicine

Shanghai, Shanghai Municipality, 200032, China

Location

Related Publications (8)

• Chen J, Zhang H, Niu D, Li H, Wei K, Zhang L, Yin S, Liu L, Zhang X, Zhang M, Liang C. The risk factors related to the severity of pain in patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. BMC Urol. 2020 Oct 7;20(1):154. doi: 10.1186/s12894-020-00729-9.

  PMID: 33028277 BACKGROUND

• Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA. 1999 Jul 21;282(3):236-7. doi: 10.1001/jama.282.3.236. No abstract available.

  PMID: 10422990 BACKGROUND

• Zhong YM, Luo XC, Chen Y, Lai DL, Lu WT, Shang YN, Zhang LL, Zhou HY. Acupuncture versus sham acupuncture for simple obesity: a systematic review and meta-analysis. Postgrad Med J. 2020 Apr;96(1134):221-227. doi: 10.1136/postgradmedj-2019-137221. Epub 2020 Feb 3.

  PMID: 32015189 BACKGROUND

• Hopton A, MacPherson H. Acupuncture for chronic pain: is acupuncture more than an effective placebo? A systematic review of pooled data from meta-analyses. Pain Pract. 2010 Mar-Apr;10(2):94-102. doi: 10.1111/j.1533-2500.2009.00337.x. Epub 2010 Jan 8.

  PMID: 20070551 BACKGROUND

• Passavanti MB, Pota V, Sansone P, Aurilio C, De Nardis L, Pace MC. Chronic Pelvic Pain: Assessment, Evaluation, and Objectivation. Pain Res Treat. 2017;2017:9472925. doi: 10.1155/2017/9472925. Epub 2017 Nov 20.

  PMID: 29359045 BACKGROUND

• Bhatt RR, Gupta A, Mayer EA, Zeltzer LK. Chronic pain in children: structural and resting-state functional brain imaging within a developmental perspective. Pediatr Res. 2020 Dec;88(6):840-849. doi: 10.1038/s41390-019-0689-9. Epub 2019 Dec 2.

  PMID: 31791045 BACKGROUND

• Ge S, Hu Q, Guo Y, Xu K, Xia G, Sun C. Potential Alterations of Functional Connectivity Analysis in the Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Neural Plast. 2021 May 7;2021:6690414. doi: 10.1155/2021/6690414. eCollection 2021.

  PMID: 34035803 BACKGROUND

• Park JJ. Developing and validating a sham acupuncture needle. Acupunct Med. 2009 Sep;27(3):93. doi: 10.1136/aim.2009.001495. No abstract available.

  PMID: 19734377 BACKGROUND

MeSH Terms

Conditions

Prostatitis

Interventions

Acupuncture Therapy

Condition Hierarchy (Ancestors)

Prostatic Diseases; Genital Diseases, Male; Genital Diseases; Urogenital Diseases; Male Urogenital Diseases

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Owing to differentiating the acupuncture effect from placebo effect, the participants and outcomes assessors are needed to be masked.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The eligible participants will receive either acupuncture or sham acupuncture randomly assigned at the ratio of 1:1 after signing the Informed consent. Before they accept the treatment, they are acquired to finish the clinical scales and get the fMRI scan. Sanyinjiao (SP6), Zhibian (BL54), Shenshu (BL23), and Huiyang (BL35) have been chosen as acupoints. In the group of both acupuncture and sham acupuncture, the course of treatment is 2 times a week in three months (totally 24 times). There are 3 clinic visits and 3 telephone contacts for emergency. At the ending of the treatment, all the volunteers will be asked to finish the clinical scales and get the fMRI scan again. As the step of following up, all the patients will be asked to finish the clinical scales and get the fMRI scan again to evaluate the efficacy of avoiding the recurrence of acupuncture.

Study Record Dates

• First Submitted: September 19, 2021
• First Posted: October 12, 2021
• Study Start: January 5, 2022
• Primary Completion: September 12, 2023
• Study Completion: December 31, 2023
• Last Updated: February 28, 2023

Record last verified: 2023-01

Locations

CN (1)