Hand Osteoarthritis Clinical Trial
Official title:
Transcutaneous Auricular Vagus Nerve Stimulation in Erosive Hand Osteoarthritis
Erosive hand osteoarthritis (EHOA) is a subtype of had osteoarthritis characterized by
inflammation and pain, with subsequent burden. Few symptomatic treatments are available in
EHOA, while this population with EHOA has frequently comorbidities.
Stimulation of the vagus nerve (VN), belonging to parasympathetic system, dampens
pro-inflammatory cytokines production by splenic macrophages, through to the binding of
acetylcholine neurotransmitter to α7nicotinic receptor on macrophages: this is the
cholinergic anti-inflammatory pathway (CAP). Beyond its anti-inflammatory effects, VNS is
analgesic in chronic pain disorders (headache, fibromyalgia). Beside implantable devices, VNS
may be performed using transcutaneous stimulation of the ascendant auricular branch of the VN
(tVNS) at the left ear localized on the cymba conchae tVNS is well-tolerated therapy avoiding
invasive neurosurgery.
The investigator do the hypothesis that auricular tVNS using a transcutaneous electrical
nerve stimulation (TENS) device could be a novel, simple and well-tolerated analgesic and
anti-inflammatory treatment of symptomatic EHOA.
In symptomatic and inflammatory EHOA patients, we will apply tNVNS using device from
Schwa-Medico (TENSeco2 + auricular electrode + conductive gel) 25 Hz stimulation will be
applied, intensity escalated up to 15 mA or below if tingling sensation.
tVNS will be performed 1 hour daily for 1 month and we will assess EHOA symptoms (pain and
function) at 1 month (end of the study)
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