Cluster Headache Clinical Trial
Official title:
Evaluation of Efficacity and Safety of Deep Brain Stimulation (DBS) in Chronic and Treatment-Resistant Cluster Headache(CH)
The aim of this study is to evaluate the efficacy and safety of deep brain stimulation (DBS) in chronic and treatment-resistant CH. Inclusion criteria are: patients with chronic CH (>3years), with daily attack and non response to adequate treatment. Electrodes are implanted stereotactically in the postero-inferior hypothalamus. In this crossover, randomized, placebo-controlled double-blinded study, the efficacy of DBS is evaluated using comparison of two one-month sequences: one with stimulation "on" and the other with stimulation "off" (placebo sequence). Efficacy is defined as ≥50% decrease of weekly frequency of CH attacks. After the randomized period, long-term efficacy and safety are evaluated after one year of stimulation in open conditions.
Over the past 7 years, deep brain stimulation (DBS) has been used in various centres to
treat patients with intractable chronic cluster headache (CH). Results in these
non-controlled studies were encouraging but need to be confirmed in controlled conditions.
The aim of this study is to evaluate the efficacy and safety of DBS in chronic and
treatment-resistant CH, in randomized placebo-controlled conditions.
Inclusion criteria are: patients with chronic CH (>3years), with daily attack and non
response to adequate treatment (verapamil up 960 mg/d, lithium with plasmatic level 0.6-1
mEq/ ml, and association of both drugs). After induction of local anaesthesia, electrodes
are implanted stereotactically in the postero-inferior hypothalamus according to the
previously described coordinates, and connected to a sub-cutaneous generator. In this
crossover, randomized, placebo-controlled double-blinded study, the efficacy of DBS is
evaluated using comparison of two one-month sequences: one with stimulation "on" and the
other with stimulation "off" (considered as the placebo sequence). Primary efficacy is
defined as ≥50% decrease of weekly frequency of CH attacks, compared to a prospective run-in
pre-implantation period. Safety and tolerability are clinically and biologically assessed.
After the randomized period, long-term efficacy and safety are evaluated after one year of
stimulation in open conditions.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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