80 Participants Needed

Noninvasive Brain Stimulation for Diabetic Neuropathy

Recruiting at 1 trial location
MO
TM
Overseen ByTerrah Morrison
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Case Western Reserve University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial
Approved in 1 JurisdictionThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether non-invasive brain stimulation can reduce pain from diabetic neuropathy, a condition causing nerve damage and pain, often in the feet. Participants will receive either real brain stimulation (Active tDCS + Active TUS, which stands for Transcranial Direct Current Stimulation and Transcranial Ultrasound) or a sham (placebo-like) treatment to compare effects. Individuals who have experienced diabetic nerve pain for at least six months and find common painkillers unhelpful might be suitable candidates for this trial. The study aims to discover a new method to ease pain that doesn't respond to usual treatments. As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group of people.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it does mention that your pain should be resistant to common pain relievers like Tylenol, Aspirin, and Ibuprofen. It also states that you should not have used carbamazepine in the past 6 months.

What prior data suggests that this non-invasive brain stimulation is safe for treating diabetic neuropathy?

Research has shown that using transcranial direct current stimulation (tDCS) and transcranial ultrasound (TUS) together is generally safe. In past studies, a 20-minute session with a current of 2 milliamps proved both effective and safe for individuals with nerve pain. The treatment is manageable, with no serious side effects reported when following standard guidelines. Overall, tDCS and similar low-intensity treatments are considered safe, with no major negative effects noted in previous research.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about the combination of transcranial direct current stimulation (tDCS) and transcranial ultrasound (TUS) for treating diabetic neuropathy because it offers a noninvasive approach that targets the brain's neural pathways. Unlike current standard treatments that often involve medications to manage symptoms, this method directly influences brain activity without drugs. This innovative approach could provide a new avenue for relief with potentially fewer side effects, making it a promising option for those who haven't found success with traditional therapies.

What evidence suggests that non-invasive brain stimulation is effective for diabetic neuropathy?

In this trial, participants will receive either an active or sham treatment. Research has shown that transcranial direct current stimulation (tDCS), administered to participants in the active treatment arm, can reduce pain in individuals with diabetic nerve pain. One study found that five daily sessions of tDCS on a specific brain area called M1 provided immediate pain relief lasting up to four weeks. Animal studies have also shown positive results, suggesting that tDCS can ease nerve pain. Researchers are exploring the combination of tDCS with transcranial ultrasound (TUS), also included in the active treatment arm, to determine if it enhances pain-relieving effects. These findings suggest that this noninvasive brain treatment could be a promising option for managing diabetic nerve pain.12345

Who Is on the Research Team?

SH

Salim Hayek, MD PhD

Principal Investigator

University Hospitals Cleveland Medical Center/ Case Western Reserve University

Are You a Good Fit for This Trial?

This trial is for adults with diabetic neuropathic pain in at least one foot, unresponsive to common painkillers, and have had this pain for over 6 months. Participants must not be pregnant, have metal in their head or implanted brain devices, a recent history of substance abuse, use of certain medications like carbamazepine, major depression, neurological disorders such as stroke or epilepsy, unexplained fainting spells, significant head injuries or neurosurgery.

Inclusion Criteria

I have had diabetic foot pain for at least 6 months, with pain most days.
My pain doesn't improve with regular painkillers like Tylenol or Ibuprofen.
I have had diabetic foot pain for at least 6 months, with pain most days and a pain level of at least 4.
See 3 more

Exclusion Criteria

I have not taken carbamazepine in the last 6 months.
I have major depression with a PHQ-9 score of 10 or higher.
I have had a head injury that caused me to lose consciousness.
See 7 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive active or sham ESStim for 5 consecutive days, 20 min/day, followed by 2 weeks of bi-weekly stimulation, 20 min/day

3 weeks
11 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment with follow-ups at 2, 4, 6, & 8 weeks post-stimulation

8 weeks
4 visits (in-person)

Long-term monitoring

Participants are assessed for changes in pain and other health measures over a 3-month period

3 months

What Are the Treatments Tested in This Trial?

Interventions

  • Active tDCS + Active TUS
  • Sham
Trial Overview The study tests if non-invasive brain stimulation (ESSTim) can better manage chronic pain from diabetic neuropathy compared to a sham (fake treatment). It involves active transcranial direct current stimulation (tDCS) combined with ultrasound therapy (TUS), versus a placebo-like device without actual therapeutic effect.
How Is the Trial Designed?
2Treatment groups
Active Control
Placebo Group
Group I: Active tDCS + Active TUSActive Control1 Intervention
Group II: ShamPlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Case Western Reserve University

Lead Sponsor

Trials
314
Recruited
236,000+

Highland Instruments, Inc.

Industry Sponsor

Trials
11
Recruited
650+

Published Research Related to This Trial

Transcranial direct current stimulation (tDCS) applied over the primary motor cortex (M1) significantly reduced pain in patients with painful diabetic polyneuropathy (PDPN), showing immediate effects and sustained relief for up to 4 weeks after treatment.
In a study of 60 patients, those receiving tDCS over M1 experienced greater pain reduction compared to those receiving sham or dorsolateral prefrontal cortex (DLPFC) stimulation, indicating that targeting M1 may be an effective approach for managing pain in PDPN.
Randomized, sham controlled trial of transcranial direct current stimulation for painful diabetic polyneuropathy.Kim, YJ., Ku, J., Kim, HJ., et al.[2022]
Transcranial direct current stimulation (tDCS) is a safe and well-tolerated technique, with no serious adverse effects reported in a study involving 131 healthy subjects across 277 sessions.
While sensory side effects like tingling and itching are common, they are generally mild; however, the higher occurrence and severity of these side effects during active stimulation compared to sham stimulation suggest that the current sham method may not be an effective control in some research contexts.
Differences in the experience of active and sham transcranial direct current stimulation.Kessler, SK., Turkeltaub, PE., Benson, JG., et al.[2021]
In a case study involving a 24-year-old female patient undergoing 10 sessions of transcranial direct current stimulation (tDCS) for anorexia nervosa, hyperglycemia developed, leading to the onset of type I diabetes.
This case highlights a potential adverse effect of tDCS on glycemic control, suggesting that while tDCS is often studied for its benefits in other areas, its impact on blood sugar levels and diabetes risk requires further investigation.
The Onset of Diabetes During Transcranial Direct Current Stimulation Treatment of Anorexia Nervosa - A Case Report.Mares, T., Ceresnakova, S., Albrecht, J., et al.[2020]

Citations

Optimization of NIBS for Diabetic Neuropathy Neuropathic ...The purpose of this study is to assess the effects of Transcranial Direct Current Stimulation (tDCS) in combination with Transcranial ultrasound ...
Evaluating the efficacy of transcranial direct current ...This review provides an overview of preclinical studies examining the effects of tDCS in rodent models of neuropathic pain.
Optimization of NIBS for Diabetic Neuropathy Neuropathic ...The purpose of this study is to assess the effects of Transcranial Direct Current Stimulation (tDCS) in combination with Transcranial ultrasound (TUS) for the ...
Randomized, Sham Controlled Trial of Transcranial Direct ...Five daily sessions of tDCS over the M1 can produce immediate pain relief, and relief 2- and 4-week in duration in patients with PDPN.
Electrical Stimulation for Diabetic Neuropathy PainResearch shows that transcranial direct current stimulation (tDCS), a part of this treatment, can help reduce pain in people with diabetic neuropathy. Studies ...
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