Treatment of Upper Limb Chronic Neuropathic Pain by Electrical Stimulation of the Brachial Plexus Nerve Roots

Launched by CENTRE HOSPITALIER UNIVERSITAIRE DE NICE · Apr 14, 2023

Keywords

ClinConnect Summary

This clinical trial is studying a new treatment option for people suffering from chronic neuropathic pain in the upper limb, specifically pain that has not improved with other treatments. The trial focuses on a method called electrical stimulation of the brachial plexus nerve roots, which is a network of nerves in the neck that control arm and hand movements. The goal is to see if this treatment can effectively reduce pain, improve quality of life, and ensure safety for those who participate.

To be eligible for the trial, participants should be between 18 and 80 years old and have been experiencing moderate to severe pain in one arm for more than a year. This pain must come from a specific nerve-related cause and should not have responded to previous treatments like medications or therapy. Participants will have the procedure performed under medical supervision and will closely monitor their progress throughout the study. It's important to note that individuals with certain health conditions or specific pain types will not be able to participate. If you or someone you know is interested, please consult with a healthcare provider for more information.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Eligibility will be determined by trained clinicians with expertise in chronic pain and neuropathic pain.
• • Patients between 18 and 80 years old
• • suffering from moderate to severe (VAS score \>5/10) chronic (duration\> 12 months) neuropathic (DN4 score ≥ 4/10) unilateral pain - located in the upper limb.
• • from peripheral origin, including complex regional pain syndrome type I and II, post-traumatic or post surgical pain.
• • refractory to first and second line treatments for neuropathic pain according recent French recommendations and guidelines\[6\], including serotonin- noradrenaline reuptake inhibitor (SNRI) antidepressants (duloxetine and venlafaxine), gabapentin, pregabalin, tricyclic antidepressants, topical lidocaine, high-concentration capsaicin patches, psychotherapy and combinations of them.
• • Patient have signed informed consent
• • - Patient benefiting from French social insurance system
• Exclusion Criteria:
• • Brachial plexus avulsion
• • Post-zoster neuropathic pain
• • Phantom limb pain
• • Patient unable to fill a self-administered questionnaire
• • Patients with a chronic disease requiring repeated MRI monitoring
• • Patients with contra-indication to general anesthesia, surgery or percutaneous BP approach.
• • Patients with other pacemakers (cardiac pacemaker or defibrillator) or patients with a high risk to use a defibrillator due to a known cardiac disorder.
• • Patients with instable neuropsychological or psychiatric disorders
• • Vulnerable patients: pregnant or breast feeding, minor, adult under guardianship or deprived freedom