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Radiofrequency Denervation and Brain Imaging

Sponsor: University of Aberdeen

NCT ID: NCT05641948

View on ClinicalTrials.gov ↗

At a glance

What the study gets you
Health checks and monitoring — no treatment given
Type of study
Observational (no treatment given)
Time in hospital
In-person visits at study sites — visit count not specified by the sponsor
Drug or intervention
MRI scan (other)
How long the study runs
Study runs about 41 months (dates as stated)
About the drug or intervention
MRI scan — other: Participants will undergo brain MRI scan at 3 intervals
Patient visit burden
Not specified by the sponsor
Type of study
Observing health over time
Ages
18 Years and over
Who
All
Number of participants
40
Started
2023-04-03
Last checked
2024-12

Plain English Summary

What is this study?

  • • Testing a new treatment for low back pain, mechanical
  • • Clinical study - 40 participants
  • • The goal of this observational study is to learn about changes in brain and its activity of following radiofrequency denervation treatment for chronic low back pain

Who can take part?

  • • Ages 18 Years and over
  • • Diagnosed with low back pain, mechanical

Where?

  • • Aberdeen - Aberdeen Royal Infirmary

This is a simplified summary. Always discuss with your doctor before making any decisions.

About This Trial

The goal of this observational study is to learn about changes in brain and its activity of following radiofrequency denervation treatment for chronic low back pain. The main question it aims to answer are: * report the magnitude of the brain changes following radiofrequency treatment for low back pain. * identify changes unique to radiofrequency treatment Patients with nociceptive type low back pain of moderate to severe intensity will be identified to undergo radiofrequency treatment. They will have 3 MRI scans - Baseline, after the diagnostic injections and 3 months after radiofrequency treatment. They will also fill questions relating to their pain, disability and health related quality of life.

More detail

Low back pain is one of the most common pain conditions and is the leading cause of years lived with disability. The management is challenging due to the heterogeneity of clinical presentation and includes self-management, pain killers, targeted injections as well as pain management programs. Brain MRI scans have identified networks of brain regions and changes in their activity in chronic low back pain (cLBP) patients. The scans have also been used to explore treatment-induced changes in brain and its activity. Radiofrequency denervation (RFD) of medial branch nerves is a NICE recommended treatment for a sub-group of cLBP sufferers. There are inter-individual variations in the response to RFD, which have been difficult to predict. The brain MRI scans can be used to better understand the effects of RFD on brain structure and function, and to predict those most likely to benefit from the interventions. So, we propose pilot study to investigate brain regions, their patterns and change after RFD treatment in this subgroup of cLBP sufferers. Eligible patients will have 3 brain MRI scans at various time intervals - Baseline, after nerve block and after RFD. These brain scans will be analysed to provide the foundations for new studies such as improved selection of patients most likely to benefit from the treatment; improved understanding of mechanisms of the RFD treatment; and develop objective measurements that could be used in future trials of pain treatments.

Low Back Pain, Mechanical

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Preliminary match based on your answers. Full eligibility requires on-site assessment including medical history, physical exam, and lab tests. This does not guarantee enrolment.

Eligibility at a Glance

Key info

  • Age: 18 Years and over
  • Who can join: All genders

What the study is looking for

  • ✓Age 18 years or older
  • ✓Chronic moderate to severe cLBP (defined by average pain intensity of ≥ 4 in the 11 point Numerical Pain rating...
  • ✓Identified by clinical team as suitable for RFD pathway
  • ✓Predominantly nociceptive pain (as defined by PainDetect score ≤12)
  • ✓Stable on current analgesic regime

Who cannot take part

  • ✗Any patient whose physical condition will preclude them from lying still for the duration of the brain scan.
  • ✗safety concern to magnetic resonance scanning such as an implantable heart device.
  • ✗Women who are, or may be, pregnant. (Pregnant patients do not undergo pain procedures under radiological guidance as...
  • ✗Significant anxiety and depression (as defined by HADS score ≥ 9)
  • ✗Clinical suspicion that alternative diagnosis is the reason for LBP
See the full criteria
Inclusion Criteria: * Age 18 years or older * Chronic moderate to severe cLBP (defined by average pain intensity of ≥ 4 in the 11 point Numerical Pain rating scale and a minimum duration of 1 year) * Identified by clinical team as suitable for RFD pathway * Predominantly nociceptive pain (as defined by PainDetect score ≤12) * Stable on current analgesic regime * Able to communicate in English * Has the capacity to and agrees to give informed consent for participation in the study * Positive response to a single diagnostic MBB with 1 ml or less of local anaesthetic (bupivacaine 0.5%) at each level. (a positive response is defined as ≥80% pain relief at 3 hours, based on patient reported assessment) Exclusion Criteria: * Any patient whose physical condition will preclude them from lying still for the duration of the brain scan. * Contraindication to magnetic resonance scanning such as an implantable cardiac device. * Women who are, or may be, pregnant. (Pregnant patients do not undergo pain procedures under radiological guidance as per routine clinical care) * Significant anxiety and depression (as defined by HADS score ≥ 9) * Clinical suspicion that alternative diagnosis is the reason for LBP * Presence of chronic primary pain conditions (Fibromyalgia, chronic widespread pain, Complex Regional Pain Syndrome, Chronic Primary Headache, Orofacial pain, Chronic primary visceral pian and Chronic Primary musculoskeletal pain as defined by ICD-11 classification) * Presence of thoracic or neck pain * History of previous RF denervation * Regular use of two or more dependence forming drugs (opioids, gabapentinoids, Benzodiazepines, tricyclics antidepressants and z-drugs)

Where Is This Study? (1 UK site)

Aberdeen Royal Infirmary

Aberdeen AB25 2 ZN, United Kingdom

Recruiting
Site contact (verified)
Saravana Kanakarajan, MD01224553237saravanakumark@abdn.ac.uk

How to Get in Touch

Saravanakumar NA Kanakarajan, Dr

Sponsor contact

CONTACT

01224 553237 Saravanakumar.kanakarajan@nhs.scot
Data sourced from ClinicalTrials.gov · Last verified: 2024-12