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Functional Imaging of the Therapeutic Effect of Pregabalin in Treatment for Neuropathic Pain

Not Applicable
Conditions
Diabetic Neuropathies
Pain
Interventions
Other: MR Spectroscopy
Registration Number
NCT01180608
Lead Sponsor
Universitair Ziekenhuis Brussel
Brief Summary

Functional Imaging of the therapeutic effect of Pregabalin in treatment for neuropathic pain in patients with Diabetic Polyneuropathy using proton Magnetic Resonance Spectroscopy (MRS):

The aim of our study is to investigate the effect of Pregabalin as a treatment for neuropathic pain in a homogeneous study population, using proton MRS (1H MRS) focusing on four regions of interest (bilateral thalami, rostral anterior cingulated cortex (rACC) and dominant dorsolateral prefrontal cortex (DLPC).

Detailed Description

spectrum measurements at: thalamus left thalamus right rostral anterior cingulated cortex dominant dorsolateral prefrontal cortex

measurements: gamma-aminobutyric acid (GABA) glutamate (Glu) glutamine (Gln) N-acetylaspartate (NAA) Choline-containing compounds (Cho) Creatine plus phophocreatine (total creatine: Cr) Myo-inositiol (Ins) Choline (Cho) Glucose (Glc) Lactate (Lac)

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Age ≥ 18 years
  • Patients with painful DPN
  • Patient willing to provide informed consent
  • Type 1 or type 2 diabetes with HbA1c ≤ 11%
  • Stable antidiabetic medication for 30 days prior to randomization
  • Duration of painful DPN ≥ 3 months
  • Visual analogue scale (VAS) score ≥ 4
Exclusion Criteria
  • Creatinine clearance ≤ 60mL/min

  • Presence of other clinically significant or disabling chronic pain condition

  • Active malignancy

  • Evidence of an active disruptive psychiatric disorder or other known condition that might influence the perception of pain, compliance to intervention and/or ability to evaluate treatment outcome as determined by the investigator

  • Life expectancy less than 1 year

  • Existing or planned pregnancy

  • Extreme fear for entering MRI

  • General contraindication for MRI (pacemaker, etc...)

  • Patients participating in other clinical trials

  • Age <18 years

  • Prior use of potential retinotoxins

  • Prohibited medications without proper wash-out period (>7days, depending on the type of medication):

    • medications and supplements commonly used for relief of neuropathic pain
    • antiepileptics
    • antidepressants (except for stable regiments of SSRIs for treatment of anxiety or depression)
    • NSAID

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PregabalinMR Spectroscopy-
placebo + pregabalinMR Spectroscopy-
Primary Outcome Measures
NameTimeMethod
cerebral neurobiological effect of pregabaline as treatment for neuropathic pain1 year

We will measure changes in neurotransmitter levels in the brain (gamma-aminobutyric acid (GABA) glutamate (Glu) glutamine (Gln) N-acetylaspartate (NAA) Choline-containing compounds (Cho) Creatine plus phophocreatine (total creatine: Cr) Myo-inositiol (Ins) Choline (Cho) Glucose (Glc) Lactate (Lac)) before and after treatment with pregabaline. Specific interest in ratio GABA/Gln and GABA/Glu: relationship between inhibitory and excitatory neurotransmittors

Secondary Outcome Measures
NameTimeMethod
cerebral neurobiological changes in relationship with dose dependent therapeutic effect of treatment with pregabaline1 year

A possible dose dependent effect of treatment with Pregabalin on cerebral neurochemical changes (gamma-aminobutyric acid (GABA) glutamate (Glu) glutamine (Gln) N-acetylaspartate (NAA) Choline-containing compounds (Cho) Creatine plus phophocreatine (total creatine: Cr) Myo-inositiol (Ins) Choline (Cho) Glucose (Glc) Lactate (Lac)) and clinical effects (pain and quality of life scales) will be evaluated

Trial Locations

Locations (1)

UZ Brussel

🇧🇪

Brussel, Belgium

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