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Cranial Electrotherapy Stimulation in the Treatment of Posttraumatic Stress Disorder (CES)

Primary Purpose

PTSD, Post Traumatic Stress Disorder

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Alpha Stim
Sponsored by
White River Junction Veterans Affairs Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional device feasibility trial for PTSD, Post Traumatic Stress Disorder

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. To ensure participants can safely receive Alpha-Stim®, eligible participants must meet all established screening criteria for safety during Alpha-Stim® using a safety screener (as assessed during phone screen and medical records review). We are screening to access for metal. These are conservative measures require a patient not having the following (unless MRI-safe): Cardiac pacemaker, implanted device (deep brain stimulation) or metal in the brain, cervical spinal cord, or upper thoracic spinal cord. The patient would additionally be required to not have an implanted cardiac defibrillator;
  2. Outpatients 18-70 years of age (inclusive);
  3. Meet DSM-V criteria for PTSD (acute or chronic) at the time of the screening and/or baseline visit; symptoms.
  4. Have a baseline score of "Moderately Ill" or worse on the CGI-S;
  5. Be on a stable psychotropic regimen for at least 6 weeks prior to baseline, or no psychotropic medication at all (for at least 6 weeks prior to baseline), and be willing to maintain the current regimen and dosing for the duration of the study (unless medically necessary to make changes with notification of research staff);

(7) If female and of child bearing potential, agree to use an acceptable method of birth control for the duration of the study treatment period; (8) Be willing and able to comply with all study related procedures and visits; (9) Be capable of independently reading and understanding patient information materials and giving written informed consent.

-

Exclusion Criteria:

Participants will be excluded from participation if they meet any of the following:

  1. Are pregnant or lactating or planning to become pregnant within the next three months;
  2. Have a lifetime history of loss of consciousness due to head injury for greater than 10 minutes, or any lifetime history of loss of consciousness due to a head injury with documented evidence of brain injury (including brain atrophy);
  3. Current (or past if appropriate) significant neurological disorder, or lifetime history of a) seizure disorder b) primary or secondary CNS tumors c) stroke or d) cerebral aneurysm;
  4. Unstable medical illness, or, in the opinion of the investigator, significant absence of appropriate medical care;
  5. Current Axis 1 primary psychotic disorder, or bipolar I disorder, active moderate/severe substance use disorders (within the last month as assessed by review of the medical records and veteran self-report, excluding nicotine/caffeine). Veterans on stable (>3 months), monitored opiate agonist therapy may be included at the investigator's discretion;
  6. Past failed treatment with rTMS or ECT; any past treatment with deep brain stimulation or vagus nerve stimulation;
  7. Have active suicidal intent or plan as detected on screening assessments, or in the Investigator's opinion, is likely to attempt suicide within the next six months;
  8. Mental retardation or cognitive impairment
  9. History of stroke, Parkinson's Disease, Multiple Sclerosis, or seizures
  10. Current use of Transcutaneous electrical nerve stimulation (TENS) unit
  11. Previous history of Alpha-Stim® use
  12. Inability to read and write in English
  13. Incapacity to make informed medical decisions for any reason
  14. Pregnancy: Pregnant women are not eligible for the study. Women with potential for pregnancy will receive a pregnancy test provided by the VA prior to the study. Women of childbearing capacity are eligible for the study. Contraceptive plans will be discussed and if they are determined to be inadequate, the participant will be excluded from the study.
  15. Presence of an implanted defibrillator or pacemaker device.
  16. Demonstrate the presence of any other condition or circumstance that, in the opinion of the investigator, has the potential to prevent study completion and/or to have a confounding effect on outcome assessments.

    -

Sites / Locations

  • White River Junction VAMC

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Use of Alpha Stim

Arm Description

Use of Alpha Stim Device

Outcomes

Primary Outcome Measures

Feasibility of Alpha-Stim® Cranial Electrotherapy Stimulation (CES) as a treatment for Posttraumatic Stress Disorder (PTSD).
We will deem the treatment feasible if ≥ 6 participants complete the protocol, based on completion of ≥ 60% treatments (3 out of 5 treatment days, weekly at home), and attending and completing ≥ 75% of the weekly assessments, including the week 1 baseline and week 4 treatment completion visit

Secondary Outcome Measures

Safety of the Alpha-Stim® Cranial Electrotherapy Stimulation (CES) as a treatment for Posttraumatic Stress Disorder.
Safety and tolerability, we expect this treatment to be safe, based on the very few adverse events and no serious adverse events in the literature and relative safety when compared to current pharmacologic treatments (e.g., SSRIs and SNRIs) for PTSD.

Full Information

First Posted
October 17, 2018
Last Updated
January 27, 2023
Sponsor
White River Junction Veterans Affairs Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT03757494
Brief Title
Cranial Electrotherapy Stimulation in the Treatment of Posttraumatic Stress Disorder
Acronym
CES
Official Title
Cranial Electrotherapy Stimulation in the Treatment of Posttraumatic Stress Disorder: A Feasibility, Safety and Efficacy Study
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
October 18, 2018 (Actual)
Primary Completion Date
September 21, 2022 (Actual)
Study Completion Date
September 21, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
White River Junction Veterans Affairs Medical Center

4. Oversight

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

5. Study Description

Brief Summary
This is a research study that will look at how well a treatment called Cranial Electrotherapy Stimulation (CES) works for patients who struggle with symptoms of Posttraumatic Stress Disorder. Cranial Electrotherapy Stimulation is delivered using a device called Alpha-Stim®. This is a safe, non-invasive treatment that applies a low-level pulsed electric current through the brain using clip-on electrodes attached to the earlobes. Cranial Electrotherapy Stimulation treats conditions such as physical pain, anxiety, and depression.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
PTSD, Post Traumatic Stress Disorder

7. Study Design

Primary Purpose
Device Feasibility
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Using Alpha Stim
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Use of Alpha Stim
Arm Type
Experimental
Arm Description
Use of Alpha Stim Device
Intervention Type
Device
Intervention Name(s)
Alpha Stim
Intervention Description
Use of Alpha Stim Device
Primary Outcome Measure Information:
Title
Feasibility of Alpha-Stim® Cranial Electrotherapy Stimulation (CES) as a treatment for Posttraumatic Stress Disorder (PTSD).
Description
We will deem the treatment feasible if ≥ 6 participants complete the protocol, based on completion of ≥ 60% treatments (3 out of 5 treatment days, weekly at home), and attending and completing ≥ 75% of the weekly assessments, including the week 1 baseline and week 4 treatment completion visit
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Safety of the Alpha-Stim® Cranial Electrotherapy Stimulation (CES) as a treatment for Posttraumatic Stress Disorder.
Description
Safety and tolerability, we expect this treatment to be safe, based on the very few adverse events and no serious adverse events in the literature and relative safety when compared to current pharmacologic treatments (e.g., SSRIs and SNRIs) for PTSD.
Time Frame
1 year
Other Pre-specified Outcome Measures:
Title
Efficacy of Alpha-Stim® Cranial Electrotherapy Stimulation (CES) as a treatment for Posttraumatic Stress Disorder.
Description
Efficacy, while the study isn't powered for an efficacy trial, the initial screening to baseline pretreatment to post-treatment change in the magnitude of change in PTSD symptoms (as measured by the PCL-5) during Alpha-Stim® treatment using paired t-tests can be used to determine sample size and power calculations for future studies.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To ensure participants can safely receive Alpha-Stim®, eligible participants must meet all established screening criteria for safety during Alpha-Stim® using a safety screener (as assessed during phone screen and medical records review). We are screening to access for metal. These are conservative measures require a patient not having the following (unless MRI-safe): Cardiac pacemaker, implanted device (deep brain stimulation) or metal in the brain, cervical spinal cord, or upper thoracic spinal cord. The patient would additionally be required to not have an implanted cardiac defibrillator; Outpatients 18-70 years of age (inclusive); Meet DSM-V criteria for PTSD (acute or chronic) at the time of the screening and/or baseline visit; symptoms. Have a baseline score of "Moderately Ill" or worse on the CGI-S; Be on a stable psychotropic regimen for at least 6 weeks prior to baseline, or no psychotropic medication at all (for at least 6 weeks prior to baseline), and be willing to maintain the current regimen and dosing for the duration of the study (unless medically necessary to make changes with notification of research staff); (7) If female and of child bearing potential, agree to use an acceptable method of birth control for the duration of the study treatment period; (8) Be willing and able to comply with all study related procedures and visits; (9) Be capable of independently reading and understanding patient information materials and giving written informed consent. - Exclusion Criteria: Participants will be excluded from participation if they meet any of the following: Are pregnant or lactating or planning to become pregnant within the next three months; Have a lifetime history of loss of consciousness due to head injury for greater than 10 minutes, or any lifetime history of loss of consciousness due to a head injury with documented evidence of brain injury (including brain atrophy); Current (or past if appropriate) significant neurological disorder, or lifetime history of a) seizure disorder b) primary or secondary CNS tumors c) stroke or d) cerebral aneurysm; Unstable medical illness, or, in the opinion of the investigator, significant absence of appropriate medical care; Current Axis 1 primary psychotic disorder, or bipolar I disorder, active moderate/severe substance use disorders (within the last month as assessed by review of the medical records and veteran self-report, excluding nicotine/caffeine). Veterans on stable (>3 months), monitored opiate agonist therapy may be included at the investigator's discretion; Past failed treatment with rTMS or ECT; any past treatment with deep brain stimulation or vagus nerve stimulation; Have active suicidal intent or plan as detected on screening assessments, or in the Investigator's opinion, is likely to attempt suicide within the next six months; Mental retardation or cognitive impairment History of stroke, Parkinson's Disease, Multiple Sclerosis, or seizures Current use of Transcutaneous electrical nerve stimulation (TENS) unit Previous history of Alpha-Stim® use Inability to read and write in English Incapacity to make informed medical decisions for any reason Pregnancy: Pregnant women are not eligible for the study. Women with potential for pregnancy will receive a pregnancy test provided by the VA prior to the study. Women of childbearing capacity are eligible for the study. Contraceptive plans will be discussed and if they are determined to be inadequate, the participant will be excluded from the study. Presence of an implanted defibrillator or pacemaker device. Demonstrate the presence of any other condition or circumstance that, in the opinion of the investigator, has the potential to prevent study completion and/or to have a confounding effect on outcome assessments. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James K Rustad, MD
Organizational Affiliation
White River Junction Veterans Affairs Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
White River Junction VAMC
City
White River Junction
State/Province
Vermont
ZIP/Postal Code
05009
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Cranial Electrotherapy Stimulation in the Treatment of Posttraumatic Stress Disorder

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