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Non-Invasive Neurostimulation for the Prevention of Chronic Migraine

Primary Purpose

Chronic Migraine

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
GammaCore Active Device
GammaCore Sham Device
Sponsored by
ElectroCore INC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Chronic Migraine focused on measuring vagus nerve stimulation, vagal nerve stimulation, nVNS, VNS, chronic migraine, migraine, non invasive, gammacore

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Is between the ages of 18 and 65 years.
  • Has been previously diagnosed as suffering from migraine, in accordance with the ICHD-2 Classification criteria (2nd), with or without aura.
  • Experiences at least 15 headache days per month (over the last 3 months).
  • Has age of onset of migraine less than 50 years old.
  • Agrees not to use any migraine prevention treatments (including Botox injections) and/or medications (exclusive of medications taken for acute relief of migraine symptoms).
  • Is able to provide written Informed Consent
  • Agrees to refrain from changing the type or dosage of any prophylactic medications for indications other than chronic migraine that in the opinion of the clinician may interfere with the study

Exclusion Criteria:

  • Has a history of aneurysm, intracranial hemorrhage, brain tumors or significant head trauma.
  • Has a lesion (including lymphadenopathy), dysaesthesia, previous surgery or abnormal anatomy at the GammaCore treatment site.
  • Has known or suspected severe atherosclerotic cardiovascular disease, severe carotid artery disease (e.g. bruits or history of TIA or CVA), congestive heart failure (CHF), known severe coronary artery disease or recent myocardial infarction.
  • Has an abnormal baseline ECG (e.g. second and third degree heart block, atrial fibrillation, atrial flutter, recent history of ventricular tachycardia or ventricular fibrillation, or clinically significant premature ventricular contraction)
  • Has had a previous bilateral, right, or left cervical vagotomy.
  • Has uncontrolled high blood pressure.
  • Is currently implanted with an electrical and/or neurostimulator device, including but not limited to cardiac pacemaker or defibrillator, vagal neurostimulator, deep brain stimulator, spinal stimulator, bone growth stimulator, or cochlear implant.
  • Has a history of carotid endarterectomy or vascular neck surgery on the right side.
  • Has been implanted with metal cervical spine hardware or has a metallic implant near the GammaCore stimulation site.
  • Has a recent or repeated history of syncope.
  • Has a recent or repeated history of seizure.
  • Has a known history or suspicion of substance abuse or addiction.
  • Has had a surgery for migraine prevention.
  • Has received Botox injections for migraine prevention within the past 6 months.
  • Has taken medications for migraine prophylaxis in the previous 30 days.
  • In the opinion of the investigator/research staff the subject is incapable of operating the GammaCore device as intended and performing the data collection procedures.
  • Is pregnant, nursing, thinking of becoming pregnant in the next 9 months, or of childbearing years and is unwilling to use an accepted form of birth control.
  • Is participating in any other therapeutic clinical investigation or has participated in a clinical trial in the preceding 30 days.
  • Belongs to a vulnerable population or has any condition such that his or her ability to provide informed consent, comply with follow-up requirements, or provide self-assessments is compromised (e.g., homeless, developmentally disabled, prisoner).
  • Is a relative of or an employee of the investigator or the clinical study site.

Sites / Locations

  • UCSF Headache Center
  • Michigan Head Pain & Neurological Institute
  • Headache Care Center
  • Montefiore Headache Center
  • Carolina Headache Institute
  • Thomas Jefferson Headache Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Sham Comparator

Arm Label

GammaCore Active Device

GammaCore Sham Device

Arm Description

Subjects will use an Active GammaCore Device

Subjects who treat with the gammacore sham device in Phase 2 will receive the active gammacore treatment during phase 3 (active treatment) of this study.

Outcomes

Primary Outcome Measures

Safety - Number of Participants With Adverse Events
Safety was assessed by collecting Adverse Effects

Secondary Outcome Measures

Mean Change in Headache Days
Mean change in headache days. Change between 4 week run in period to the 8 weeks randomized period.
Total Number of Headache Days Per Arm With Peak Severity of Mild, Moderate, or Severe
Peak severity per headache day was reported each headache day in the subject diary. Pain was reported as mild, moderate or severe. Whereas as mild = least severe and severe = most severe.
Use of Pain Relief Medication
All abortive headache medication taken during randomized period
Mean Change in Quality of Life Short Form Survey (SF-12)
The Quality of Life Short Form Survey (SF-12) is a multipurpose short form survey with 12 questions that are combined, scored and weighted to create two scales that provide glimpses into mental and physical functioning and overall health-related-quality of life. The SF-12 is weighted and summed to provide easily interpretable scales for physical and mental health. Physical and Mental Health Composite Scores (PCS & MCS) are computed using the scores of the twelve questions and range from 0 to 100, where a zero score indicates the lowest level of health measured by the scales and 100 indicates the highest level of health. SF-12 were recorded in the subject diary at the Phase 1 follow-up visit (week 4) and during Phase 2 randomized period at week 4 and week 8.

Full Information

First Posted
August 15, 2012
Last Updated
May 22, 2018
Sponsor
ElectroCore INC
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1. Study Identification

Unique Protocol Identification Number
NCT01667250
Brief Title
Non-Invasive Neurostimulation for the Prevention of Chronic Migraine
Official Title
Non-Invasive Neurostimulation of the Vagus Nerve With the GammaCore Device for the Prevention of Chronic Migraine
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
October 2012 (undefined)
Primary Completion Date
May 2014 (Actual)
Study Completion Date
May 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ElectroCore INC

4. Oversight

5. Study Description

Brief Summary
The purpose of this multi-center, prospective, double-blind, randomized, sham-controlled pilot study is to study feasibility and collect preliminary clinical data related to the safety and clinical benefits of daily use of non-invasive vagal nerve stimulation with the GammaCore device for the prevention of chronic migraine, and to support the development and approval of a larger pivotal study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Migraine
Keywords
vagus nerve stimulation, vagal nerve stimulation, nVNS, VNS, chronic migraine, migraine, non invasive, gammacore

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
59 (Actual)

8. Arms, Groups, and Interventions

Arm Title
GammaCore Active Device
Arm Type
Active Comparator
Arm Description
Subjects will use an Active GammaCore Device
Arm Title
GammaCore Sham Device
Arm Type
Sham Comparator
Arm Description
Subjects who treat with the gammacore sham device in Phase 2 will receive the active gammacore treatment during phase 3 (active treatment) of this study.
Intervention Type
Device
Intervention Name(s)
GammaCore Active Device
Intervention Type
Device
Intervention Name(s)
GammaCore Sham Device
Primary Outcome Measure Information:
Title
Safety - Number of Participants With Adverse Events
Description
Safety was assessed by collecting Adverse Effects
Time Frame
Up to 8 weeks - duration of the Randomized period
Secondary Outcome Measure Information:
Title
Mean Change in Headache Days
Description
Mean change in headache days. Change between 4 week run in period to the 8 weeks randomized period.
Time Frame
Run-in period (4 weeks no treatment) and Randomized period (8 weeks)
Title
Total Number of Headache Days Per Arm With Peak Severity of Mild, Moderate, or Severe
Description
Peak severity per headache day was reported each headache day in the subject diary. Pain was reported as mild, moderate or severe. Whereas as mild = least severe and severe = most severe.
Time Frame
Run-in (4 weeks no treatment) and Randomized (8 weeks)
Title
Use of Pain Relief Medication
Description
All abortive headache medication taken during randomized period
Time Frame
Randomized period - 8 weeks
Title
Mean Change in Quality of Life Short Form Survey (SF-12)
Description
The Quality of Life Short Form Survey (SF-12) is a multipurpose short form survey with 12 questions that are combined, scored and weighted to create two scales that provide glimpses into mental and physical functioning and overall health-related-quality of life. The SF-12 is weighted and summed to provide easily interpretable scales for physical and mental health. Physical and Mental Health Composite Scores (PCS & MCS) are computed using the scores of the twelve questions and range from 0 to 100, where a zero score indicates the lowest level of health measured by the scales and 100 indicates the highest level of health. SF-12 were recorded in the subject diary at the Phase 1 follow-up visit (week 4) and during Phase 2 randomized period at week 4 and week 8.
Time Frame
Run-in (4 weeks) and Randomized period (8 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is between the ages of 18 and 65 years. Has been previously diagnosed as suffering from migraine, in accordance with the ICHD-2 Classification criteria (2nd), with or without aura. Experiences at least 15 headache days per month (over the last 3 months). Has age of onset of migraine less than 50 years old. Agrees not to use any migraine prevention treatments (including Botox injections) and/or medications (exclusive of medications taken for acute relief of migraine symptoms). Is able to provide written Informed Consent Agrees to refrain from changing the type or dosage of any prophylactic medications for indications other than chronic migraine that in the opinion of the clinician may interfere with the study Exclusion Criteria: Has a history of aneurysm, intracranial hemorrhage, brain tumors or significant head trauma. Has a lesion (including lymphadenopathy), dysaesthesia, previous surgery or abnormal anatomy at the GammaCore treatment site. Has known or suspected severe atherosclerotic cardiovascular disease, severe carotid artery disease (e.g. bruits or history of TIA or CVA), congestive heart failure (CHF), known severe coronary artery disease or recent myocardial infarction. Has an abnormal baseline ECG (e.g. second and third degree heart block, atrial fibrillation, atrial flutter, recent history of ventricular tachycardia or ventricular fibrillation, or clinically significant premature ventricular contraction) Has had a previous bilateral, right, or left cervical vagotomy. Has uncontrolled high blood pressure. Is currently implanted with an electrical and/or neurostimulator device, including but not limited to cardiac pacemaker or defibrillator, vagal neurostimulator, deep brain stimulator, spinal stimulator, bone growth stimulator, or cochlear implant. Has a history of carotid endarterectomy or vascular neck surgery on the right side. Has been implanted with metal cervical spine hardware or has a metallic implant near the GammaCore stimulation site. Has a recent or repeated history of syncope. Has a recent or repeated history of seizure. Has a known history or suspicion of substance abuse or addiction. Has had a surgery for migraine prevention. Has received Botox injections for migraine prevention within the past 6 months. Has taken medications for migraine prophylaxis in the previous 30 days. In the opinion of the investigator/research staff the subject is incapable of operating the GammaCore device as intended and performing the data collection procedures. Is pregnant, nursing, thinking of becoming pregnant in the next 9 months, or of childbearing years and is unwilling to use an accepted form of birth control. Is participating in any other therapeutic clinical investigation or has participated in a clinical trial in the preceding 30 days. Belongs to a vulnerable population or has any condition such that his or her ability to provide informed consent, comply with follow-up requirements, or provide self-assessments is compromised (e.g., homeless, developmentally disabled, prisoner). Is a relative of or an employee of the investigator or the clinical study site.
Facility Information:
Facility Name
UCSF Headache Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Michigan Head Pain & Neurological Institute
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48104
Country
United States
Facility Name
Headache Care Center
City
Springfield
State/Province
Missouri
ZIP/Postal Code
65807
Country
United States
Facility Name
Montefiore Headache Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10461
Country
United States
Facility Name
Carolina Headache Institute
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27516
Country
United States
Facility Name
Thomas Jefferson Headache Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
27412146
Citation
Silberstein SD, Calhoun AH, Lipton RB, Grosberg BM, Cady RK, Dorlas S, Simmons KA, Mullin C, Liebler EJ, Goadsby PJ, Saper JR; EVENT Study Group. Chronic migraine headache prevention with noninvasive vagus nerve stimulation: The EVENT study. Neurology. 2016 Aug 2;87(5):529-38. doi: 10.1212/WNL.0000000000002918. Epub 2016 Jul 13.
Results Reference
derived
Links:
URL
https://www.ncbi.nlm.nih.gov/pubmed/24607501
Description
Effect of noninvasive vagus nerve stimulation on acute migraine: An open-label pilot study

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Non-Invasive Neurostimulation for the Prevention of Chronic Migraine

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