Neuralgia

This research aims to evaluate the effectiveness and duration of pain relief provided by a single infusion of 2R,6R-hydroxynorketamine compared with ketamine and saline in adults with chronic neuropathic pain of the extremities lasting longer than three months. The study is a randomized, double-blind, three-way crossover trial designed to compare these treatments on pain intensity, pain qualities, physical function, pain interference, sleep disturbance, and quality of life. Participants will receive each of the three study drugs2R,6R-hydroxynorketamine, ketamine, and salinein a random order, with each infusion given over 45 minutes and spaced five weeks apart, totaling a 15-week treatment period. The study uses a crossover design where participants experience all treatments in different sequences. Safety and efficacy are monitored throughout, with baseline and follow-up assessments including blood tests, ECGs, and physical exams. During the study, participants will undergo quantitative sensory and pain evaluations before the first treatment and on days 7, 14, 21, and 35 after each infusion. They will also complete patient-reported pain outcome questionnaires to assess changes in pain and related symptoms. Researchers will monitor safety, lab results, vital signs, and liver function throughout the trial. Participants are advised to continue their regular pain medications and use additional analgesics only as needed. The total study duration per participant is approximately 15 weeks of treatment plus assessment periods.

Researchers are studying how muscle and brain interactions relate to neurodegenerative diseases NDGs such as Amyotrophic Lateral Sclerosis, Alzheimers Disease, and Parkinsons Disease, as well as aging. The study explores whether changes at the neuromuscular junction, where muscle and nerve communicate, contribute to these conditions. It aims to identify factors that influence brain-muscle connections and how these may predict disease progression or aging outcomes. This observational case-control study includes two groups a Good Aging group of adults aged 60 or older without muscle or neurological impairments, and a Bad Aging group with patients diagnosed with NDGs or severe acquired brain injury, some with sarcopenia or cognitive issues. Researchers will collect clinical and biological data, including biomarkers, microRNA, and extracellular vesicle analyses, to better understand the muscle-brain relationship and movement issues. Participants will undergo assessments including the Edmonton Frail Scale at the start and after six months to measure frailty changes. The study will gather neurological and muscular phenotyping data to track participants health trajectories. The study spans from baseline to a 6-month follow-up, monitoring physical and cognitive function to inform future clinical strategies for minimizing risks linked to aging and neurological disorders.

Researchers are studying the safety and effectiveness of a single dose of nexiguran ziclumeran NTLA-2001 compared to a placebo in people with hereditary transthyretin amyloidosis with polyneuropathy ATTRv-PN. This phase 3, multinational, randomized, double-blind, placebo-controlled trial involves about 60 participants with this nerve disease and genetic condition affecting the peripheral nervous system. Participants will be randomly assigned to receive a single intravenous infusion of either nexiguran ziclumeran 55 mg or a placebo of normal saline. To give everyone a chance to receive the study drug, participants may switch to the other treatment group at either 12 or 18 months, depending on specific study criteria. The study is designed to compare the effects of the drug and placebo over time. During the study, participants will be monitored for nerve function using the Modified Neuropathy Impairment Score 7 mNIS7 over 18 months and blood levels of serum transthyretin at 29 days and 18 months. Quality of life, body mass index, and other health measures will also be evaluated. The study includes careful safety monitoring and will last up to 18 months with ongoing assessments to track participants nerve health and overall well-being.

This research aims to evaluate a freezing technique called cryoneurolysis to see if it helps reduce pain in adults with trigeminal neuralgia, a condition causing severe facial pain. The study is a randomized, triple-blinded trial comparing the freezing treatment with a sham procedure to determine its safety and effectiveness. Researchers want to find out how many participants experience at least a 75% reduction in pain and will also collect other important information about pain relief and side effects. Participants will be randomly assigned to either receive the cryoneurolysis treatment or a sham stimulation device. Before treatment, all participants will keep a daily headache diary for two weeks. After treatment, they will continue recording pain for four weeks. Following this initial period, there is an extension phase lasting up to two years where all participants can receive treatment as needed. The study involves careful monitoring of pain levels and any treatment-related adverse events during weeks 1 to 4 post-intervention. During the study, participants will have their pain recorded daily using pain scales and diaries. Researchers will evaluate average daily pain intensity, responder rates based on various pain and impression scales, and safety outcomes. The study includes baseline and follow-up assessments to compare pain levels before and after treatment. Participants ability to maintain their usual medication regime is required, and safety monitoring will continue throughout the study period. Total participation time can last up to two years with long-term follow-up opportunities.

Researchers are evaluating the effectiveness of Acceptance and Commitment Therapy ACT-based group therapy for improving mental health in people with mixed neurological disorders, including those with post-COVID conditions. These disorders often involve cognitive difficulties that can affect psychotherapy outcomes. This study focuses on whether the therapy improves mental health symptoms and how executive functions, especially abstract thinking, relate to social participation and mental health after therapy. The study involves an ACT-based group therapy program adapted from a manual for neurological conditions. Participants join groups of three to six people and attend eight weekly 100-minute sessions led by licensed psychotherapists. Before the therapy, participants spend eight weeks on a waiting list. The therapy uses metaphors and imagery and aims to improve psychological flexibility. Participants will be assessed before and after the waiting list period and therapy using various psychological tests and questionnaires measuring depression, anxiety, stress, and cognitive functions. Researchers will monitor therapy motivation, cognition, and language ability. The total participation includes the waiting period and therapy sessions, with outcomes measured approximately eight weeks apart to evaluate changes in mental health and executive function.

This research aims to evaluate the added effect of Amantadine or Duloxetine when combined with Pregabalin on the development of post mastectomy pain syndrome PMPS, a common chronic pain condition occurring after breast surgery. PMPS affects 20% to 50% of patients and is a type of chronic post-surgical pain. The study investigates how these medications might influence pain pathways and nerve excitability in patients undergoing modified radical mastectomy for breast cancer. Participants are assigned randomly to one of three groups. Two hours before surgery, one group receives Pregabalin 75 mg with a placebo tablet another group receives Pregabalin 75 mg plus Amantadine 100 mg and the third group receives Pregabalin 75 mg plus Duloxetine 30 mg. All treatments are continued twice daily for seven days after surgery. This double-blind study compares the effect of these treatments on pain development following mastectomy. During the study, researchers will monitor the occurrence of post mastectomy pain syndrome 12 weeks after surgery as the primary outcome. Secondary outcomes include patient quality of life, activity level, pain severity at 12 weeks, and opioid use during and after surgery. Side effects related to each medication are tracked for 48 hours post-procedure. Participants are evaluated through clinical assessments and medication monitoring over the course of the treatment and follow-up period.

Researchers are evaluating the effects of combining an adductor canal block with an IPACK infiltration versus using an adductor canal block alone on post-operative pain and opioid use in patients undergoing high tibial osteotomy HTO, distal femoral osteotomy DFO, or tibial tubercle osteotomy TTO. This randomized, single-blind, single-center study focuses on improving pain management after these orthopedic surgeries. Participants are randomly assigned to receive either an adductor canal block ACB combined with an IPACK block or an adductor canal block alone. The ACB involves injecting 15 mL of 0.25% Bupivacaine under ultrasound guidance to block the saphenous nerve, while the IPACK block administers 20 mL of 0.25% Bupivacaine into the space between the popliteal artery and the knee capsule. These treatments are given around the time of surgery to assess their impact on post-operative pain and opioid consumption. During the study, researchers will measure opioid use during the first 24 hours after surgery as the primary outcome. Secondary outcomes include pain scores reported by patients at various time points up to six months after surgery, length of stay in the post-anesthesia care unit, and physical function scores related to knee injury and osteoarthritis. Participants will be monitored for safety, pain control, and recovery progress throughout the post-operative period and follow-up visits up to six months after surgery.

Researchers are evaluating two non-invasive brain stimulation techniques, high frequency repetitive transcranial magnetic stimulation rTMS and accelerated intermittent theta burst stimulation aiTBS, to reduce chronic neuropathic pain lasting at least 6 months. This randomized controlled trial with a crossover design compares these methods to sham stimulation, aiming to assess their analgesic effects and identify factors predicting treatment response. The study includes adults aged 18 to 80 with neuropathic pain and uses brain stimulation targeting pain-related brain regions. The trial involves two treatment phases where participants receive either active or sham stimulation. Active rTMS consists of 5 daily sessions over 5 consecutive days, each lasting 25 to 30 minutes with 1500 pulses per session. Active aiTBS delivers 5 sessions in a single day with breaks between sessions, each lasting about 8 minutes and also delivering 1500 pulses per session. Sham stimulation mimics the active treatments but uses an inactive coil face and low-intensity electrical stimulation to maintain blinding. A 4 to 6-week washout period separates the two treatment phases. Participants undergo about 11 to 12 in-person visits over 10 to 12 weeks. Assessments include self-reported pain diaries using the numeric pain rating scale, validated questionnaires on pain and quality of life, resting-state EEG, and transcranial magnetic stimulation measures of brain excitability. Researchers monitor changes in pain intensity and other outcomes from before treatment through three weeks after treatment. The study also explores neurophysiological and clinical predictors to personalize chronic pain treatment.

This research aims to understand neuropathic pain in children and adolescents who had limb amputations during childhood. It focuses on two types of neuropathic pain phantom limb pain and residual limb pain. The study also looks at quality of life and functional independence in these young patients, exploring links between pain, autonomy, quality of life, and age when the amputation occurred. This observational study uses both past medical records and questionnaires to gather information without changing patient care. Participants are children and teens aged 5 to 18 years who had limb amputations before age 15 for girls and 16 for boys. The study collects data from medical records and standardized questionnaires during routine follow-up visits at a specialized pediatric limb anomaly center. There is no treatment or intervention data collection happens at a single time point to assess neuropathic pain and its effects. During the study, participants provide information through questionnaires about neuropathic pain, quality of life, and functional abilities. Researchers also review medical records for relevant history. The main measure is the presence of neuropathic pain after amputation. Other outcomes include types of pain, health-related quality of life, locomotor and upper limb function, and correlations between pain scores and age at amputation. Participation involves only one visit during routine care, with no extra procedures or treatments.

This research aims to evaluate the effectiveness of the Capsaicin 8% cutaneous patch compared to a hydrocolloid dressing in children aged 12 to 17 years who have local chronic neuropathic pain lasting more than three months after trauma or surgery. The study is a multicenter, randomized controlled trial designed to assess pain relief and safety in this pediatric population. Participants include children with persistent neuropathic pain despite oral treatments or those with less severe pain without prior oral treatment. Participants receive either the Capsaicin 8% patch or a hydrocolloid dressing applied to intact, non-irritated, dry skin at baseline. If needed, a second application is done three months later. The patch is applied for 30 minutes on the feet or 60 minutes on other body areas. Tolerance to the treatment is monitored during and after each application, including phone follow-ups until cold need stops. Children are followed monthly for four months after the first application through clinical consultations to assess effectiveness. Assessments include the Neuropathic Pain Symptom Inventory score, adverse event monitoring, vital signs, dermal evaluations, pain related to treatment, use of analgesics, and functional disability. The total participation duration is approximately four months with regular monitoring to evaluate both safety and efficacy outcomes.