Investigation of Nonconvulsive Electrotherapy (NET) for Chronic Pain
Abstract
About 50% of American Veterans experience chronic pain, which is defined as pain persisting at least 3 months or more past the expected time of healing that does not resolve with treatment. In addition to considerable suffering, chronic pain is associated with major depression and the risk of developing an addiction. This includes not only pain killers, but also alcohol and marijuana, as patients try to self-medicate and relieve their symptoms. Furthermore, the presence of major depression increases the likelihood of developing pain that is chronic and disabling. Our goal in this study is to investigate NET (non-convulsive electrotherapy) for chronic pain. NET is similar to electroconvulsive therapy (ECT) in that an electrical stimulus is delivered to the brain. However, the dose of stimulation used for NET is lower than ECT, so that no seizure is generated. A previous publication has shown that NET is effective for treatment-resistant depression, without the effects on memory that can accompany ECT. Thus, NET holds promise as a potential treatment for both chronic pain and major depressive disorder, while not causing the same side effects. We propose to investigate the feasibility of NET in participants with chronic pain. This will be an open-label study where all participants are administered eight to nine sessions of NET over 3 weeks. We plan to enroll 12 patients with chronic pain, half of whom will also have major depression. Participants will be asked to complete questionnaires about their symptoms of pain, depression, sleep, and quality of life. They will also undergo cognitive testing to demonstrate that NET does not have the effects on memory and attention that are seen with ECT. Our hypothesis is that NET will be feasible in this patient population and will have few side effects. We also hypothesize that NET will have a beneficial effect on pain and symptoms of depression. In the event that we see a positive response from patients, we will move forward with a larger clinical trial. Our goal is to perform this proposed pilot study over 2 years, so that a larger study could start soon after. The main side effects of NET include the inadvertent delivery of a seizure (which is addressed by lowering the stimulation dose further), blood pressure changes, and irregular heartbeats. An anesthesiologist with expertise in ECT and neuro-anesthesia will be present at all sessions. NET will be delivered using the ECT suite at our institution, which has all of the equipment and safety protocols in place for this procedure. Ultimately, our goal is to find an innovative treatment for chronic pain that does not involve an additional medication or the risk of addiction. We are looking into NET because it uses the same equipment as ECT, meaning that it could be performed at most medical centers around the country, especially Department of Veterans Affairs (VA) clinics and hospitals. Repurposing existing treatments has the potential to bring an idea to clinical practice quickly, which would serve to improve the medical care of our country’s military personnel.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210416
Entities
People
- Diana Martinez
Organizations
- Research Foundation For Mental Hygiene
- United States Army