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Examining Carryover Effect in Patients Treated witH Spinal cOrd Stimulation (ECHO)

Examining Carryover Effect in Patients Treated witH Spinal cOrd Stimulation (ECHO). An Open, Prospective, Multicenter Study.

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03386058
Acronym
ECHO
Enrollment
200
Registered
2017-12-29
Start date
2018-01-31
Completion date
2021-03-30
Last updated
2021-05-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Neuralgia, Spinal Cord Stimulation

Brief summary

Spinal cord stimulation is a minimally invasive surgical treatment for severe, chronic, neuropathic pain that is refractory to conventional treatment. The treatment consists of an electrode implanted in the epidural space of the spinal cord, either via a percutaneous approach (using the so-called percutaneous leads) or via a surgical (hemi-) laminectomy (using the so-called surgical leads or plate leads). It is a well-known clinical observation that when activating or deactivating SCS stimulation, there is a variable interval before the patient perceives a clinical effect of the change. This variation goes by different names (carryover, echo, after effect, etc.) and might be dependent on the clinical condition and treatment duration. To our knowledge only very little research has been published on the topic of carryover effects; a recent study showed that the interval is highly variable between patients. While patients may experience immediate pain relief at the onset of SCS treatment, the effect in patients with a long-term SCS treatment history may have different characteristics, possibly due to ongoing changes in the nervous system. The aim of this pilot study is to lay the foundation for investigating the carryover effects in spinal cord stimulation. This will be carried out in a mixed population of patients with different indications for SCS, and with different treatment durations. Patients will be asked to deactivate their device via their remote control or with a magnet in a standardized fashion. They will be asked to reactivate the device when specific parameters have been met, and the time is recorded.

Detailed description

In the post-hoc analysis the carryover and reverse carryover effect will be analyzed and correlated to a number of parameters including, but not limited to: Indication, treatment duration, symptom duration, preoperative pain score, stimulation paradigm, gender, age. Data will be collected and stored using a dedicated REDCap database under the auspices of Aarhus University.

Interventions

DEVICETemporary device deactivation

Patient-controlled, temporary deactivation of implanted device

Sponsors

Aarhus University Hospital
CollaboratorOTHER
CHU de Quebec-Universite Laval
CollaboratorOTHER
Medisch Spectrum Twente
CollaboratorOTHER
Odense University Hospital
CollaboratorOTHER
Aalborg University Hospital
CollaboratorOTHER
Sahlgrenska University Hospital
CollaboratorOTHER
Diakoniekrankenhaus Friederikenstift
CollaboratorOTHER
Sunderby Hospital
CollaboratorOTHER
Erasmus Medical Center
CollaboratorOTHER
AZ Delta
CollaboratorOTHER
University of Aarhus
Lead SponsorOTHER

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE

Intervention model description

Open study

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* patient age minimum 18 years * signed informed consent * implanted with full SCS system for neuropathic pain * SCS treatment duration minimum 6 months before inclusion * maximum pain score 7 or less on a 0-10 NRS at the area of pain treated with SCS during the last 48 hours before study-related deactivation of the device

Exclusion criteria

* any surgical SCS lead revision for the last 6 months before inclusion * any changes in the programming patterns of the device (except patient-controlled changes in amplitude) for a minimum of 30 days before the study-related deactivation of the device * any other ongoing neuromodulatory treatment (PNS, TENS, etc.) * any other neuromodulatory treatment with lasting effect (RFA, sympathectomy, infiltration anesthesia, nerve blockade) within the last 60 days * any changes in analgetic medication within the last 30 days (pn. dosings are allowed)

Design outcomes

Primary

MeasureTime frameDescription
Carryover/echo effect: Time from deactivation of device to cessation of treatment affectUp to one week (may be repeated)Time from deactivation of device to cessation of treatment affect

Secondary

MeasureTime frameDescription
Reverse carryover/echo effect: Time from reactivation of device to full reestablishment of treatment effectUp to one week (may be repeated)Time from reactivation of device to full reestablishment of treatment effect

Countries

Belgium, Canada, Denmark, Germany, Netherlands, Sweden

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 8, 2026