Chronic Cluster HeadachePhase 2/3ANODECCHNCT02462395
Anodal Transcranial Direct Stimulation (tDCS) for the Treatment of Chronic Cluster Headache
A Phase 2/3 study testing tDCS in people with Chronic Cluster Headache, run by University of Liege at 1 site in Belgium.
Trial summary
Cluster headache is a primary headache that chiefly affects young men, and is less common than migraine. This disease can have devastating consequences due to the pain intensity (it is also called "suicide headache"), to the side effects of the drug preventive therapies, and to the resistance of some subtypes of the… Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Chronic Cluster Headache
- What is being tested?
- tDCS
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 32 participants
- Where
- 1 siteBelgium
- Study dates
- Sep 2014to Sep 2016
- Phase
- Phase 2/3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Main inclusion criteria for CCH: preventive CH therapy stable for a least 2 months, retrospective 4-week headache baseline diary showing at least 4 attacks/week on average
Who cannot join
- No other significant medical or psychiatric disease.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Anodal Transcranial Direct Stimulation (tDCS) of the Anterior Cingulate Gyrus for the Treatment of Chronic Cluster Headache: a Pilot Trial.
Cluster headache is a primary headache that chiefly affects young men, and is less common than migraine. This disease can have devastating consequences due to the pain intensity (it is also called "suicide headache"), to the side effects of the drug preventive therapies, and to the resistance of some subtypes of the headache to all existing medications.
Recent studies suggest that cluster headache could be associated with a decrease of the activity of frontal areas involved in descending pain control, in particular the subgenual anterior cingulate cortex. The aim of this pilot study is to activate these areas with a non-invasive neurostimulation technique, called transcranial direct current stimulation, as a preventive treatment for cluster headache sufferers.
Read the detailed description
Cluster headache affects 0.1%-0.25% of the general population, but its prevalence may be underestimated. It is a primary headache disorder with a higher prevalence in young males, characterized by attacks of severe unilateral periorbital/temporal pain with autonomic symptoms (ie lacrimation, nasal congestion, eyelid edema, Horner's…) and agitation, lasting 15 to 180 minutes and occurring periodically in bouts (clusters) in about 90% of patients (episodic cluster headache or ECH, ICHD-III criteria 3.1.1).In 10% of patients there is no sustained spontaneous remission for long periods, which defines chronic cluster headache (CCH, ICHD-III criteria 3.1.2).
The pathophysiology of cluster headache is not completely understood, but neuroimaging studies clearly suggest that activation of the ipsilateral postero-ventral hypothalamus plays a seminal role during the attack. Recent findings suggest that prefrontal areas may be dysfunctioning in cluster headache patients. The investigator shave shown in CCH patients that the beneficial effects of ONS are associated with activation of the subgenual anterior cingulate cortex, an area responsible for descending pain-control. Transcranial direct current stimulation (tDCS) allows activating the underlying cortex and connected subcortical structures under the anode or inhibiting them under the cathode. tDCS was used as a therapeutic strategy in various neurological disorders, chronic pain disorders and depression. Because of its non-invasiveness, It is of particular interest in primary headaches where various brain areas are known to function abnormally even between headache attacks. It has been tested in migraine but not in cluster headache.
In a recent study, the investigators have shown that anodal tDCS over the visual cortex is able to modify visual evoked potentials in healthy volunteers and migraineurs, and after a 2-month treatment of 2 weekly sessions to significantly decrease attack frequency in episodic migraine.
CCH patients will have to apply the neurostimulation outside of an attack every day for 20 minutes during 4 to 8 weeks.
Adherence to the treatment will be evaluated by monitoring the time during which the device is switched on via an in-built software.
- Conditions
- Chronic Cluster Headache
- Being tested
- tDCS
- Medical subject headings
- Cluster Headache
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
tDCSDevice
Also called tDCS Cefaly Technology°.
Sponge-electrodes (5 x 7 cm) will be postioned at Fz (anode) and over the spinous process of C7 (cathode). Stimulation intensity will be set to 2 mA.
A first group of CCH patients will have to apply the neurostimulation outside of an attack every day for 20 minutes during 4 weeks. A second group will use the tDCS device everyday for 8 weeks.
Adherence to the treatment will be evaluated by monitoring the time during which the device is switched on via an in-built software.
| Study group | Role | What they receive |
|---|---|---|
| Cefaly tDCS | Experimental | Sponge-electrodes (5 x 7 cm) will be postioned at Fz (anode) and over the spinous process of C7 (cathode). Stimulation intensity will be set to 2 mA. Receives: Device: tDCS |
What is being measured
The primary outcome is the main question the study is designed to answer.
Reduction of weekly cluster headache attack frequency during and following tDCS treatment in CCH patients.
Analysis of the headache diary
Measured: 4 to 8 weeks
Secondary outcomes (5)
reduction of intensity of CH attacks
Analysis of the headache diary
Measured: 4 to 8 weeks
reduction of duration of CH attacks
Analysis of the headache diary
Measured: 4 to 8 weeks
reduction of acute medication intake
Analysis of the headache diary
Measured: 4 to 8 weeks
modification of the nociceptive blink reflex
Measured: 4 to 8 weeks
modification of pain thresholds
using quantitative sensory testing
Measured: 4 to 8 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Jun 2015 (estimated)
- Study startSep 2014
- Primary completionSep 2016
- Study completionSep 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic Cluster HeadacheStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2/3
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 32 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Liege
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Jean Schoenen, University of Liege
- Investigators
- Delphine Magis, MD, Principal investigator, University of Liege
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02462395
- Sponsor's protocol ID
- ANODECCH
- Acronym
- ANODECCH
- Status last verified
- Dec 2016
- First submitted
- 27 May 2015
- Last updated
- 7 Dec 2016
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 7 Dec 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Anodal Transcranial Direct Stimulation (tDCS) of the Anterior Cingulate Gyrus for the Treatment of Chronic Cluster Headache: a Pilot Trial.
- ClinicalTrials.gov ID
- NCT02462395
- Acronym / sponsor ID
- ANODECCH / ANODECCH
- Conditions
- Chronic Cluster Headache
- Phase
- Phase 2/3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 32 participants (actual)
- Lead sponsor
- University of LiegeUniversity, hospital or other
- Study start
- Sep 2014
- Primary completion
- Sep 2016 (actual)
- Study completion
- Sep 2016 (actual)
- First posted
- 4 Jun 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Cluster headache is a primary headache that chiefly affects young men, and is less common than migraine. This disease can have devastating consequences due to the pain intensity (it is also called "suicide headache"), to the side effects of the drug preventive therapies, and to the resistance of some subtypes of the headache to all existing medications.
Recent studies suggest that cluster headache could be associated with a decrease of the activity of frontal areas involved in descending pain control, in particular the subgenual anterior cingulate cortex. The aim of this pilot study is to activate these areas with a non-invasive neurostimulation technique, called transcranial direct current stimulation, as a preventive treatment for cluster headache sufferers.
Detailed description
Cluster headache affects 0.1%-0.25% of the general population, but its prevalence may be underestimated. It is a primary headache disorder with a higher prevalence in young males, characterized by attacks of severe unilateral periorbital/temporal pain with autonomic symptoms (ie lacrimation, nasal congestion, eyelid edema, Horner's…) and agitation, lasting 15 to 180 minutes and occurring periodically in bouts (clusters) in about 90% of patients (episodic cluster headache or ECH, ICHD-III criteria 3.1.1).In 10% of patients there is no sustained spontaneous remission for long periods, which defines chronic cluster headache (CCH, ICHD-III criteria 3.1.2).
The pathophysiology of cluster headache is not completely understood, but neuroimaging studies clearly suggest that activation of the ipsilateral postero-ventral hypothalamus plays a seminal role during the attack. Recent findings suggest that prefrontal areas may be dysfunctioning in cluster headache patients. The investigator shave shown in CCH patients that the beneficial effects of ONS are associated with activation of the subgenual anterior cingulate cortex, an area responsible for descending pain-control. Transcranial direct current stimulation (tDCS) allows activating the underlying cortex and connected subcortical structures under the anode or inhibiting them under the cathode. tDCS was used as a therapeutic strategy in various neurological disorders, chronic pain disorders and depression. Because of its non-invasiveness, It is of particular interest in primary headaches where various brain areas are known to function abnormally even between headache attacks. It has been tested in migraine but not in cluster headache.
In a recent study, the investigators have shown that anodal tDCS over the visual cortex is able to modify visual evoked potentials in healthy volunteers and migraineurs, and after a 2-month treatment of 2 weekly sessions to significantly decrease attack frequency in episodic migraine.
CCH patients will have to apply the neurostimulation outside of an attack every day for 20 minutes during 4 to 8 weeks.
Adherence to the treatment will be evaluated by monitoring the time during which the device is switched on via an in-built software.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Cefaly tDCS | Experimental | Device: tDCSSponge-electrodes (5 x 7 cm) will be postioned at Fz (anode) and over the spinous process of C7 (cathode). Stimulation intensity will be set to 2 mA. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Main inclusion criteria for CCH: preventive CH therapy stable for a least 2 months, retrospective 4-week headache baseline diary showing at least 4 attacks/week on average
Key exclusion criteria (1 listed)
- No other significant medical or psychiatric disease.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| tDCSAlso: tDCS Cefaly Technology°.Sponge-electrodes (5 x 7 cm) will be postioned at Fz (anode) and over the spinous process of C7 (cathode). Stimulation intensity will be set to 2 mA. A first group of CCH patients will have to apply the neurostimulation outside of an attack every day for 20 minutes during 4 weeks. A second group will use the tDCS device everyday for 8 weeks. Adherence to the treatment will be evaluated by monitoring the time during which the device is switched on via an in-built software. | Device | Cefaly tDCS |
Primary outcome
Reduction of weekly cluster headache attack frequency during and following tDCS treatment in CCH patients.
Time frame: 4 to 8 weeks
Analysis of the headache diary
5 secondary outcomes
reduction of intensity of CH attacks
Time frame: 4 to 8 weeks
reduction of duration of CH attacks
Time frame: 4 to 8 weeks
reduction of acute medication intake
Time frame: 4 to 8 weeks
modification of the nociceptive blink reflex
Time frame: 4 to 8 weeks
modification of pain thresholds
Time frame: 4 to 8 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Dec 2016.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Delphine Magis, MD principal investigator
University of Liege
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2/3 study testing tDCS in people with Chronic Cluster Headache, run by University of Liege at 1 site in Belgium.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 7 Dec 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Reduction of weekly cluster headache attack frequency during and following tDCS treatment in CCH patients. (time frame: 4 to 8 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Dec 2016.