Non Invasive Neuromodulation for Patients With Motor Control Disorders

November 19, 2020 updated by: Universidad Francisco de Vitoria

Development and Clinical Validation of a Rehabilitation Platform Based on Neuromodulation for Patients With Motor Control Disorders

Movement disorders are neurological syndromes leading to excessive movements or to limited control of voluntary and automatic movements. Many of these disorders are not life-threatening but represent serious difficulties in carrying out the activities of daily living and reduce patient's independence and quality of life.

This project NeuroMOD (neuromodulation for patients with disorders of motor control) proposes the development of a neuromodulation-based platform for the rehabilitation and restoration of motor and cognitive functions of patients suffering from Parkinson's disease (PD). Our project will focus on the application of a novel neurorehabilitation strategy, its functional and clinical validation, and on the evaluation of the impact of the use of the technologies involved in the musculoskeletal and the nervous system as well as user behavior.

Parkinson's disease was selected as target pathology since it represents a paradigm of motor disorder diseases.

Parkinson's disease affects adults and has a very high prevalence and a very high functional impact.

In order to achieve this objective, we have defined the following research areas:

Subproject 1. NeuroMOD: development of a neuromodulation platform composed by a TMS system, and an EMG (electromyography) and EEG (electroencephalography) system in combination with a system of virtual reality based on immersive glasses.

Subproject 2. NeuroMOD-PD: development of therapies and evaluation of clinical evidence and motor and cognitive impact of NeuroMOD in the rehabilitation of patients suffering from Parkinson's disease impact.

Subproject 3. NeuroMOD-Image: development of neuroimaging techniques to investigate the brain areas affected by the proposed therapies and temporary terms that neural plasticity is induced and evolves in Parkinson´s Disease.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

50

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 90 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Idiopathic Parkinsons Disease
  • Hoehn Yahr Scale I-III
  • No drug changes in the last 90 days
  • No exclusion criteria

Exclusion Criteria:

  • Dementia (Minimental scale score <25)
  • Dependency (modified Rankin scale > 3)
  • Pregnancy or pregnancy plans
  • Pacemaker
  • Implanted metal devices
  • cochlear implants
  • claustrophobia
  • drug infusion pumps
  • epilepsy / epileptiform anomalies in electroencephalography (EEG)
  • known structural alterations in magnetic resonance imaging (MRI)
  • Atypical Parkinsonism
  • Previous repetitive transcranial magnetic stimulation (rTMS)
  • Severe comorbidity (cancer, severe debilitating diseases, etc.)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Repetitive stimulating transcranial stimulation (rTMS)
Subjects receive 8 sessions M1 Neuromodulation using rTMS according to the protocol ( 80% resting motor threshold, 10 Hertz; 1000 pulses; 25 trains de 4 seconds con 25 seconds intertrain.
The intervention intends to change the cortical plasticity in specific cortical areas. rTMS is a non-invasive exogenous neuromodulation technique that uses repetitive magnetic pulses administered in a specific area of the head in order to influence the connectivity of the underlying brain area.
Experimental: EEG guided Neurofeedback (NFB)
Subjects receive 8 sessions M1 EEG guided NFB with virtual reality goggles in order to modify the beta rhythm. The sessions have a duration of 20min
The intervention intends to change the cortical plasticity in specific cortical areas. The NFB is a non-invasive endogenous technique that seeks the self-regulation of cortical activity through the information represented in a videogame which is used to interact with the subject.
Experimental: rTMS + NFB
Subjects receive both interventions sequentially
The intervention intends to change the cortical plasticity in specific cortical areas. rTMS is a non-invasive exogenous neuromodulation technique that uses repetitive magnetic pulses administered in a specific area of the head in order to influence the connectivity of the underlying brain area.
The intervention intends to change the cortical plasticity in specific cortical areas. The NFB is a non-invasive endogenous technique that seeks the self-regulation of cortical activity through the information represented in a videogame which is used to interact with the subject.
No Intervention: No intervention
No interventions, the patient just comes to be evaluated sequentially according to the timing of experimental groups.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Motor changes
Time Frame: The day before the first stimulation session and 2 weeks after the first stimulation session
UNIFIED PARKINSON'S DISEASE RATING SCALE (UPDRS) part III ( total values from 0-68, higher score worse clinical situation)
The day before the first stimulation session and 2 weeks after the first stimulation session
Motor changes
Time Frame: t2(2 weeks after finishing the protocol)
UNIFIED PARKINSON'S DISEASE RATING SCALE (UPDRS) part III ( total values from 0-68, higher score worse clinical situation)
t2(2 weeks after finishing the protocol)
Neurophysiological cortical changes
Time Frame: The day before the first stimulation session and 2 weeks after the first stimulation session
Cortical silent period measured using transcranial magnetic pulse in M1 and simultaneous register of electromyographical response
The day before the first stimulation session and 2 weeks after the first stimulation session
Neurophysiological cortical changes
Time Frame: t2(2 weeks after finishing the protocol)
Cortical silent period measured using transcranial magnetic pulse in M1 and simultaneous register of electromyographical response
t2(2 weeks after finishing the protocol)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Quality of life changes
Time Frame: t2(2 weeks after finishing the protocol)
Changes in PDQ 39 (The 39-Item Parkinson's Disease Questionnaire) score, common range of 0-100 (100 = maximum level of problems).
t2(2 weeks after finishing the protocol)
Encephalographic changes
Time Frame: t2(2 weeks after finishing the protocol)
Changes in microstates of electro encephalography (presence of state A, B, C, D and E)
t2(2 weeks after finishing the protocol)
Cognitive changes in objective measures of processing speed
Time Frame: t2(2 weeks after finishing the protocol)
Changes in cognitive processing speed using computer based reaction time task
t2(2 weeks after finishing the protocol)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2016

Primary Completion (Actual)

December 20, 2018

Study Completion (Actual)

September 30, 2019

Study Registration Dates

First Submitted

July 2, 2019

First Submitted That Met QC Criteria

July 11, 2019

First Posted (Actual)

July 12, 2019

Study Record Updates

Last Update Posted (Actual)

November 20, 2020

Last Update Submitted That Met QC Criteria

November 19, 2020

Last Verified

July 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • NeuroMOD

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Individual anonymized participant data will be available to other researchers under request.

IPD Sharing Time Frame

six months after the end of the study

IPD Sharing Access Criteria

Individual anonymized participant data will be available to other researchers under request.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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