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Clinical Trial of Wireless CranioFacial Nerve Stimulation (CFNS) for the Treatment of CranioFacial Neuropathic Pain

Primary Purpose

Facial Pain

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Halo Craniofacial Nerve Stimulator System
Sponsored by
Stimwave Technologies
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Facial Pain

Eligibility Criteria

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

Inclusion Criteria:

  • Subject is ≥ 18 years of age at time of informed consent
  • Subjects have been diagnosed with Cranial-facial pain with an average VAS > 5 (on a 0-10 scale) over the course of the last month based on baseline pain diary.
  • Subject diagnosis with neuropathic cranial-facial pain refractory to conventional medical management for at least 12 months prior to enrollment;
  • Based on the medical opinion of the Principal Investigator, subject has a stable pain medication regimen for 3 months prior to study entry.
  • Based on the medical opinion of the Principal Investigator, subject has a stable Tricyclic regimen for 3 months prior to study entry
  • No medication overuse and not attributed to another causative disorder
  • Based on the medical opinion of the Principal Investigator, there is no evidence of anatomic abnormalities that could jeopardize the placement of the device or pose a hazard to the subject;
  • Based on the opinion of the Principal Investigator, subject is willing and able to operate the patient programmer, recharging equipment, diary and has the ability to undergo study assessments and provide accurate responses;
  • Based on the opinion of the implanter, subject is a good surgical subject for the implant procedure;
  • Subject is willing to undergo surgical implant procedure, attend visits as scheduled, and comply with the study requirements;
  • Subject is male or non-pregnant female as determined with a negative pregnancy test at baseline visit, and if sexually active, must be using a medically acceptable method of contraception for the duration of their study participation;
  • Subject is deemed to be neuro-psycho-socially appropriate for implantation therapies based of the assessment of a Clinical Psychologist, using face-to-face encounters and the psychological testing described in the measures;
  • Patient is capable of giving informed consent

Exclusion Criteria:

  • A. Subject has undergone botulinum toxin (BOTOX) injections of the head and/or neck in the last 3 months.
  • Unresolved Malignancies in last six months;
  • Subject has a history of migraine, headaches of central origin or trigeminal autonomic cephalalgias;
  • Subject has postherpetic neuralgia (shingles);
  • Complete deafferentation of all branches of the trigeminal, facial, occipital nerves and cervical plexus;
  • Subject has an active systemic infection or is immune-compromised;
  • Based on the medical opinion of the Principal Investigator, Psychologist and/or Psychiatrist, the subject has other psychological conditions (e.g., psychosis, suicidal ideation, borderline personality disorder, somatization, narcissism), other health conditions (e.g., substance abuse, another chronic condition requiring the regular use of opioid medication), or other legal concerns that would preclude his/her enrollment in the study or potentially confound the results of the study;
  • Subject is currently enrolled in or plans to enroll in any concurrent drug and/or device study while participating in this study;
  • Insulin-dependent diabetic who is not controlled through diet and/or medication (determined by the physician) or non-insulin dependent diabetic who is not well controlled through diet and/or medication;
  • Bleeding complications or coagulopathy issues;
  • Pregnant/lactating or not using adequate birth control;
  • A life expectancy of less than one year;
  • Any active implanted device whether turned off or on;
  • A previous peripheral nerve stimulator (PNS) experience for the treatment of facial pain including a failed trial or explanted device;
  • Conditions requiring Magnetic Resonance Imaging (MRI) evaluation or diathermy procedures;
  • Subject is currently involved in litigation regarding injury, or is receiving worker's compensation benefits.

Sites / Locations

  • International Spine, Pain & Performance Center
  • Goodman Campbell Brain and Spine, Indiana University
  • Prizm Pain Management
  • Minimally Invasive Pain Institute
  • University Hospitals Case Medical Center, Department of Anesthesiology, Division of Pain Medicine
  • Pennsylvania Hospital, Dept. of Neurosurgery
  • baylor College of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Continued Stimulation Group

Delayed Continuation Group

Arm Description

Subjects randomized to this group will have the Halo Craniofacial Nerve Stimulator System activated immediately.

Subjects randomized to this group with have the Halo Craniofacial Nerve Stimulator System activated after 90 days.

Outcomes

Primary Outcome Measures

Pain Score
To achieve a sustained 50% reduction in pain measured by the Visual Analog Scale (VAS)
Incidence and severity of adverse events

Secondary Outcome Measures

Percentage change from baseline in VAS for facial pain
Percent change from baseline in the Brief Pain Inventory-facial (BPIF) Questionnaire
Subject satisfaction with the therapy as measured by the Patient Global Impression of Change (PGIC)
Change from baseline in quality of life, Physical component score using Medical Outcomes Short Form SF-36
Change from baseline in quality of life, Mental component score using Medical Outcomes Short Form SF-36
Change from baseline in pain rating index from the Short Form McGill Pain Questionnaire (MPQ-SF-2)

Full Information

First Posted
March 29, 2016
Last Updated
October 11, 2023
Sponsor
Stimwave Technologies
Collaborators
Goodman Campbell Brain and Spine, Indiana University, Indianapolis, Indiana, USA, International Spine, Pain and Performance Center, Washington DC, USA, Minimally Invasive Pain Institute, Utica, New York, USA, Case Western Reserve University, Cleveland, Ohio, USA, Pennsylvania Hospital, Philadelphia, Pennsylvania, USA, Baylor College of Medicine, Prizm Pain Management, Canton, Michigan
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1. Study Identification

Unique Protocol Identification Number
NCT02729480
Brief Title
Clinical Trial of Wireless CranioFacial Nerve Stimulation (CFNS) for the Treatment of CranioFacial Neuropathic Pain
Official Title
Multi-center, Prospective, Controlled, Clinical Trial of Wireless CranioFacial Nerve Stimulation (CFNS) for the Treatment of CranioFacial Neuropathic Pain
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Completed
Study Start Date
February 1, 2017 (Actual)
Primary Completion Date
February 1, 2022 (Actual)
Study Completion Date
October 1, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stimwave Technologies
Collaborators
Goodman Campbell Brain and Spine, Indiana University, Indianapolis, Indiana, USA, International Spine, Pain and Performance Center, Washington DC, USA, Minimally Invasive Pain Institute, Utica, New York, USA, Case Western Reserve University, Cleveland, Ohio, USA, Pennsylvania Hospital, Philadelphia, Pennsylvania, USA, Baylor College of Medicine, Prizm Pain Management, Canton, Michigan

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the effectiveness of craniofacial nerve stimulation for the treatment of neuropathic pain.
Detailed Description
Subjects will be randomized at enrollment into either a delayed or immediate continuation group. The immediate continuation group will immediately continue with the stimulation after a 30-day trial period and will be monitored for a total of 12 months. The delayed activation group will have their device turned off after the 30-day trial period for the next 3-months. At the 3-month visit, both groups be evaluated and the delayed activation group will have their devices reactivated. Subjects will have neuropathic pain of various etiologies, including trauma, surgery or post-herpetic infections. Stimulators will be placed at the site target of the painful area, including the epifascial plane under the skin but above the muscles in the vicinity of the targeted branches of; A. Branches of Trigeminal Nerves in the Ophthalmic, Maxillary, or Mandibular B. Sensory branches of Facial Nerves C. Branches of the Occipital Nerves (Greater and/or Lesser) D. Branches of the Cervical Plexus (Superficial and/or Deep)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Facial Pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Continued Stimulation Group
Arm Type
Experimental
Arm Description
Subjects randomized to this group will have the Halo Craniofacial Nerve Stimulator System activated immediately.
Arm Title
Delayed Continuation Group
Arm Type
Active Comparator
Arm Description
Subjects randomized to this group with have the Halo Craniofacial Nerve Stimulator System activated after 90 days.
Intervention Type
Device
Intervention Name(s)
Halo Craniofacial Nerve Stimulator System
Intervention Description
The Halo Craniofacial Nerve Stimulator System is a wirelessly powered neurostimulator for pain in the face or head (not for headaches or migraine). This technology includes an implanted stimulator with an embedded receiver. The energy source is a small, external, rechargeable transmitter, which is worn by the patient. The transmitter sends the therapy program and power through the skin to the receiver.
Primary Outcome Measure Information:
Title
Pain Score
Description
To achieve a sustained 50% reduction in pain measured by the Visual Analog Scale (VAS)
Time Frame
3 months
Title
Incidence and severity of adverse events
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Percentage change from baseline in VAS for facial pain
Time Frame
Baseline and 3 months
Title
Percent change from baseline in the Brief Pain Inventory-facial (BPIF) Questionnaire
Time Frame
Baseline and 3 months
Title
Subject satisfaction with the therapy as measured by the Patient Global Impression of Change (PGIC)
Time Frame
3 months
Title
Change from baseline in quality of life, Physical component score using Medical Outcomes Short Form SF-36
Time Frame
Baseline and 3 months
Title
Change from baseline in quality of life, Mental component score using Medical Outcomes Short Form SF-36
Time Frame
Baseline and 3 months
Title
Change from baseline in pain rating index from the Short Form McGill Pain Questionnaire (MPQ-SF-2)
Time Frame
Baseline and 3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is ≥ 18 years of age at time of informed consent Subjects have been diagnosed with Cranial-facial pain with an average VAS > 5 (on a 0-10 scale) over the course of the last month based on baseline pain diary. Subject diagnosis with neuropathic cranial-facial pain refractory to conventional medical management for at least 12 months prior to enrollment; Based on the medical opinion of the Principal Investigator, subject has a stable pain medication regimen for 3 months prior to study entry. Based on the medical opinion of the Principal Investigator, subject has a stable Tricyclic regimen for 3 months prior to study entry No medication overuse and not attributed to another causative disorder Based on the medical opinion of the Principal Investigator, there is no evidence of anatomic abnormalities that could jeopardize the placement of the device or pose a hazard to the subject; Based on the opinion of the Principal Investigator, subject is willing and able to operate the patient programmer, recharging equipment, diary and has the ability to undergo study assessments and provide accurate responses; Based on the opinion of the implanter, subject is a good surgical subject for the implant procedure; Subject is willing to undergo surgical implant procedure, attend visits as scheduled, and comply with the study requirements; Subject is male or non-pregnant female as determined with a negative pregnancy test at baseline visit, and if sexually active, must be using a medically acceptable method of contraception for the duration of their study participation; Subject is deemed to be neuro-psycho-socially appropriate for implantation therapies based of the assessment of a Clinical Psychologist, using face-to-face encounters and the psychological testing described in the measures; Patient is capable of giving informed consent Exclusion Criteria: A. Subject has undergone botulinum toxin (BOTOX) injections of the head and/or neck in the last 3 months. Unresolved Malignancies in last six months; Subject has a history of migraine, headaches of central origin or trigeminal autonomic cephalalgias; Subject has postherpetic neuralgia (shingles); Complete deafferentation of all branches of the trigeminal, facial, occipital nerves and cervical plexus; Subject has an active systemic infection or is immune-compromised; Based on the medical opinion of the Principal Investigator, Psychologist and/or Psychiatrist, the subject has other psychological conditions (e.g., psychosis, suicidal ideation, borderline personality disorder, somatization, narcissism), other health conditions (e.g., substance abuse, another chronic condition requiring the regular use of opioid medication), or other legal concerns that would preclude his/her enrollment in the study or potentially confound the results of the study; Subject is currently enrolled in or plans to enroll in any concurrent drug and/or device study while participating in this study; Insulin-dependent diabetic who is not controlled through diet and/or medication (determined by the physician) or non-insulin dependent diabetic who is not well controlled through diet and/or medication; Bleeding complications or coagulopathy issues; Pregnant/lactating or not using adequate birth control; A life expectancy of less than one year; Any active implanted device whether turned off or on; A previous peripheral nerve stimulator (PNS) experience for the treatment of facial pain including a failed trial or explanted device; Conditions requiring Magnetic Resonance Imaging (MRI) evaluation or diathermy procedures; Subject is currently involved in litigation regarding injury, or is receiving worker's compensation benefits.
Facility Information:
Facility Name
International Spine, Pain & Performance Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20037
Country
United States
Facility Name
Goodman Campbell Brain and Spine, Indiana University
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Prizm Pain Management
City
Canton
State/Province
Michigan
ZIP/Postal Code
48187
Country
United States
Facility Name
Minimally Invasive Pain Institute
City
Utica
State/Province
New York
ZIP/Postal Code
13502
Country
United States
Facility Name
University Hospitals Case Medical Center, Department of Anesthesiology, Division of Pain Medicine
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Pennsylvania Hospital, Dept. of Neurosurgery
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19106
Country
United States
Facility Name
baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified participant data for all primary endpoints will be made available within 6 months of study completion.

Learn more about this trial

Clinical Trial of Wireless CranioFacial Nerve Stimulation (CFNS) for the Treatment of CranioFacial Neuropathic Pain

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