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Efficacy and Mechanism of Acupuncture for Chronic Sciatica Using fMRI

Primary Purpose

Chronic Sciatica

Status
Unknown status
Phase
Not Applicable
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Real acupuncture
Sham acupuncture
Sponsored by
Kyung Hee University Hospital at Gangdong
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Sciatica focused on measuring acupuncture, sciatica, MRI, functional

Eligibility Criteria

19 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • adults 19 years of age or more and 70 years of age or less
  • clinical diagnosis of chronic sciatica (pain lasting 3 months or more)
  • 40mm or more of 100mm VAS for bothersomeness due to sciatica
  • volunteers through announcements and advertisements with written informed consent

Exclusion Criteria:

  • spinal surgery within the past 6 months
  • diagnosis of specific severe diseases resulting in sciatica: malignant tumor, spinal infection, inflammatory sponlylitis
  • progressive neurological deficit or severe neurological signs
  • other chronic diseases which could disturb the effect of treatments and the results of the study: cardiovascular diseases, autoimmune diseases, renal diseases, diabetic neuropathy, dementia, epilepsy
  • inadequate or insafe for the treatment of acupuncture/ electroacupuncture: hemorrhagic diseases, medication of anticoagulant, serious diabetes mellitus vulnerable to infections, serious cardiovascular diseases/ pacemaker, metal materials interior of the body
  • currently or might be pregnant
  • severe mental illness
  • currently participating other clinical trials
  • experience of acupuncture or electroacupuncture treatment, or taking medicines which might affect the symptom of pain such as corticosteroids, narcotics, NSAIDs or considered to be inadequate by the investigators within the past week (But they could be included only after going through 2 weeks of wash out period.)
  • difficulty of writing informed consent
  • inadeguate or insafe for MRI scanning: claustrophobia, metal materials interor of the body
  • other inadequate subjects assessed by the study investigators

Sites / Locations

  • Kyung Hee University Hospital at GangdongRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Sham Comparator

Arm Label

Real acupuncture

Sham acupuncture

Arm Description

manual acupuncture + electroacupuncuture on acupoints, twice a week, for 4 weeks

sham acupuncture (no skin penetration) + placebo electroacupuncture without electrical stimulation on acupoints, twice a week, for 4 weeks

Outcomes

Primary Outcome Measures

Visual analogue scale for bothersomeness
change in visual analoge scale for bothersomeness [range: 0(better)-100(worse) mm]

Secondary Outcome Measures

Visual analogue scale for pain intensity
change in visual analogue scale for pain intensity [range: 0(better)-100(worse) mm]
Oswestry Disability Index
change in functional scale: Oswestry Disability Index [10 items, 0-5 points each, total 0(better) -50(worse) points]
EuroQol 5-Dimension
change in quality of life scale: EuroQol 5-Dimension [5 items, 1-3 points each, total 5(better) -15(worse) points]
Coping Strategy Questionnaire
change in coping scale: Coping Strategy Questionnaire [8 subscales, total 48 items, 0-6 points each, divided into adaptive coping or disadaptive coping, not better or worse]
Beck Depression Inventory
change in emotion scale: Beck Depression Inventory [21 items, 1-4 points each, total 21(better) -84(worse) points]
State-Trait Anxiety Inventory
change in emotion scale: State-Trait Anxiety Inventory [40 items, 1-4 points each, divided into state anxiety or trait anxiety, not better or worse]
blood oxygenation level dependent in Magnetic Resonance Image, functional
change in blood oxygenation level dependent of steady state and event-related block design scan run in functional magnetic resonance image. cf. functional magnetic resonance image scan run design: REST(6 min)-TASK1(5 min)-3D T1(5 min)-TASK2(5 min)-DTI(6 min)-TASK3(6 min). REST: steady-state resting scan run. TASK1/2: event-related block design, emotion and pain stimulation model scan run. 2 distinct 5-min experiment blocks (each block-20(5*4) stimuli (6 sec, inter-stimulus interval: 9 sec); comprised of visual picture(International Affective Picture System: neutral, negative), pain(low back, hand), picture plus pain). 3D T1: structural image acquisition. DTI: diffusion tensor imaging. TASK3: steady state pain model scan run. Low back extension pain model.
Adverse events
number of participants with adverse events assessment of severity: mild, moderate, severe assessment of relation: definitely related, probably related, possibly related, probably not related, definitely not related, unknown

Full Information

First Posted
November 15, 2017
Last Updated
April 17, 2018
Sponsor
Kyung Hee University Hospital at Gangdong
Collaborators
National Research Foundation of Korea
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1. Study Identification

Unique Protocol Identification Number
NCT03350789
Brief Title
Efficacy and Mechanism of Acupuncture for Chronic Sciatica Using fMRI
Official Title
Efficacy and Mechanism of Acupuncture on Patients With Chronic Sciatica Using fMRI: A Randomized, Patient-Assessor Blind, Sham-Controlled Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Unknown status
Study Start Date
April 9, 2018 (Actual)
Primary Completion Date
January 2021 (Anticipated)
Study Completion Date
February 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Kyung Hee University Hospital at Gangdong
Collaborators
National Research Foundation of Korea

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This research is planned to build a basis about the efficacy and mechanism of acupuncture on pain and emotional disorder in patients with chronic sciatica using fMRI.
Detailed Description
Clinical research to assess the effect of acupuncture for chronic sciatica on pain and emotional disorder will be processed with randomized, patient-assessor blinding, and sham-acupuncture controlled study design. Sixty eight subjects would be collected and divided into two groups(experimental and placebo, 34 subjects each). Experimental group will undergo with real acupuncture treatment(manual acupuncture + electroacupuncture) and placebo group will undergo with sham acupuncture treatment (acupuncture without skin penetration + electroacupuncture without electrical stimulation) twice a week, for 4 weeks. The effect on parameters related with pain and emotional disorder will be assessed at 1(baseline: just before the beginning of treatment) and 5(primary end point: 1 week after the end of treatment) weeks. Functional magnetic resonance imaging will be also conducted for 52 subjects(experimental and placebo, 20 among 34 subjects each + normal control 12 subjects) at 1 and 5 weeks to seek machanism of acupuncture.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Sciatica
Keywords
acupuncture, sciatica, MRI, functional

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
68 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Real acupuncture
Arm Type
Experimental
Arm Description
manual acupuncture + electroacupuncuture on acupoints, twice a week, for 4 weeks
Arm Title
Sham acupuncture
Arm Type
Sham Comparator
Arm Description
sham acupuncture (no skin penetration) + placebo electroacupuncture without electrical stimulation on acupoints, twice a week, for 4 weeks
Intervention Type
Device
Intervention Name(s)
Real acupuncture
Intervention Description
manual acupuncture(0.25mm diameter x 40mm length, stainless steel, Dongbangacupuncture Inc., Korea) (unilateral GB30) + electroacupuncture(0.25mm diameter x 40mm length, stainless steel, Dongbangacupuncture Inc., Korea) (unilateral EX-B2 (L4 & L5), BL25, BL23, BL40, GB34), twice a week, for 4 weeks, common approaches for the treatment of chronic sciatica used by doctors of Korean medicine in Korea today
Intervention Type
Device
Intervention Name(s)
Sham acupuncture
Intervention Description
sham acupuncture without skin penetration(0.25mm diameter x 40mm length, stainless steel, Acuprime, UK) (unilateral GB30) + placebo electroacupuncture (0.25mm diameter x 40mm length, stainless steel, Dongbangacupuncture Inc., Korea) without electrical stimulation (unilateral EX-B2, BL25, BL23, BL40, GB34), twice a week, for 4 weeks
Primary Outcome Measure Information:
Title
Visual analogue scale for bothersomeness
Description
change in visual analoge scale for bothersomeness [range: 0(better)-100(worse) mm]
Time Frame
baseline, 1-1, 1-2, 2-1, 2-2, 3-1, 3-2, 4-1, 4-2, 5, and 8 weeks
Secondary Outcome Measure Information:
Title
Visual analogue scale for pain intensity
Description
change in visual analogue scale for pain intensity [range: 0(better)-100(worse) mm]
Time Frame
baseline, 1-1, 1-2, 2-1, 2-2, 3-1, 3-2, 4-1, 4-2, 5, and 8 weeks
Title
Oswestry Disability Index
Description
change in functional scale: Oswestry Disability Index [10 items, 0-5 points each, total 0(better) -50(worse) points]
Time Frame
week 1(before treatment) and week 5(1 week after treatment, primary endpoint)
Title
EuroQol 5-Dimension
Description
change in quality of life scale: EuroQol 5-Dimension [5 items, 1-3 points each, total 5(better) -15(worse) points]
Time Frame
week 1(before treatment) and week 5(1 week after treatment, primary endpoint)
Title
Coping Strategy Questionnaire
Description
change in coping scale: Coping Strategy Questionnaire [8 subscales, total 48 items, 0-6 points each, divided into adaptive coping or disadaptive coping, not better or worse]
Time Frame
week 1(before treatment) and week 5(1 week after treatment, primary endpoint)
Title
Beck Depression Inventory
Description
change in emotion scale: Beck Depression Inventory [21 items, 1-4 points each, total 21(better) -84(worse) points]
Time Frame
week 1(before treatment) and week 5(1 week after treatment, primary endpoint)
Title
State-Trait Anxiety Inventory
Description
change in emotion scale: State-Trait Anxiety Inventory [40 items, 1-4 points each, divided into state anxiety or trait anxiety, not better or worse]
Time Frame
week 1(before treatment) and week 5(1 week after treatment, primary endpoint)
Title
blood oxygenation level dependent in Magnetic Resonance Image, functional
Description
change in blood oxygenation level dependent of steady state and event-related block design scan run in functional magnetic resonance image. cf. functional magnetic resonance image scan run design: REST(6 min)-TASK1(5 min)-3D T1(5 min)-TASK2(5 min)-DTI(6 min)-TASK3(6 min). REST: steady-state resting scan run. TASK1/2: event-related block design, emotion and pain stimulation model scan run. 2 distinct 5-min experiment blocks (each block-20(5*4) stimuli (6 sec, inter-stimulus interval: 9 sec); comprised of visual picture(International Affective Picture System: neutral, negative), pain(low back, hand), picture plus pain). 3D T1: structural image acquisition. DTI: diffusion tensor imaging. TASK3: steady state pain model scan run. Low back extension pain model.
Time Frame
week 1(before treatment) and week 5(1 week after treatment, primary endpoint)
Title
Adverse events
Description
number of participants with adverse events assessment of severity: mild, moderate, severe assessment of relation: definitely related, probably related, possibly related, probably not related, definitely not related, unknown
Time Frame
baseline, 1-1, 1-2, 2-1, 2-2, 3-1, 3-2, 4-1, 4-2, 5, and 8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: adults 19 years of age or more and 70 years of age or less clinical diagnosis of chronic sciatica (pain lasting 3 months or more) 40mm or more of 100mm VAS for bothersomeness due to sciatica volunteers through announcements and advertisements with written informed consent Exclusion Criteria: spinal surgery within the past 6 months diagnosis of specific severe diseases resulting in sciatica: malignant tumor, spinal infection, inflammatory sponlylitis progressive neurological deficit or severe neurological signs other chronic diseases which could disturb the effect of treatments and the results of the study: cardiovascular diseases, autoimmune diseases, renal diseases, diabetic neuropathy, dementia, epilepsy inadequate or insafe for the treatment of acupuncture/ electroacupuncture: hemorrhagic diseases, medication of anticoagulant, serious diabetes mellitus vulnerable to infections, serious cardiovascular diseases/ pacemaker, metal materials interior of the body currently or might be pregnant severe mental illness currently participating other clinical trials experience of acupuncture or electroacupuncture treatment, or taking medicines which might affect the symptom of pain such as corticosteroids, narcotics, NSAIDs or considered to be inadequate by the investigators within the past week (But they could be included only after going through 2 weeks of wash out period.) difficulty of writing informed consent inadeguate or insafe for MRI scanning: claustrophobia, metal materials interor of the body other inadequate subjects assessed by the study investigators
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Koh-Woon Kim, Ph.D.
Phone
82-2-440-7577
Email
garson83@hanmail.net
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mi-Yeon Song, Ph.D.
Organizational Affiliation
Department of Rehabilitation Medicine of Korean Medicine, Kyung Hee University Hospital at Gangdong
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kyung Hee University Hospital at Gangdong
City
Seoul
ZIP/Postal Code
05278
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Koh-Woon Kim
Phone
82-2-440-7581
Email
omdkimkw@khu.ac.kr

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
30651139
Citation
Kim KW, Park K, Park HJ, Jahng GH, Jo DJ, Cho JH, Song EM, Shin WC, Yoon YJ, Kim SJ, Eun S, Song MY. Effect and neurophysiological mechanism of acupuncture in patients with chronic sciatica: protocol for a randomized, patient-assessor blind, sham-controlled clinical trial. Trials. 2019 Jan 16;20(1):56. doi: 10.1186/s13063-018-3164-8.
Results Reference
derived

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Efficacy and Mechanism of Acupuncture for Chronic Sciatica Using fMRI

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