rTMS Improves Functions in Spinocerebellar Ataxia

October 16, 2023 updated by: Sen-yung Liu, Changhua Christian Hospital

Repetitive Transcranial Magnetic Stimulation Improves Functional Performance in Spinocerebellar Ataxia

Spinocerebellar ataxia (SCA) is a group of inherited brain disorders. SCA often result in poor limb coordination. This study aims to discover the effects of repeated transcranial magnetic stimulation (rTMS) on balance & gait in SCA. The hypothesis of this study is that rTMS might improve SCA limb functional performance.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

rTMS has been shown that improves walking speed and balance performance, however, the optimal treatment protocols have not been approved. Past studies used different frequencies 1 Hz, 5 Hz and 10 Hz to improve functional performance. The results might be affected by the types of SCA. In this study, we will focus on the SCA type 3 to assess the effects on high frequency (10 Hz) of rTMS intervention.

Study Type

Interventional

Enrollment (Estimated)

10

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Changhua, Taiwan, 500
        • Recruiting
        • Changhua Christian Hospital
        • Contact:

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • SCA type 3
  • independently walk with/without an assistive device
  • SARA greater than 3

Exclusion Criteria:

  • Epilepsy history
  • Unstable blood pressure
  • Brain Trauma
  • Alcoholism, drug abuse, antipsychotics drug use
  • Metallic hardware (e.g. - cochlear implants, brain stimulators or electrodes, aneurysm clips) anywhere in head.
  • Dementia, depression

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: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: rTMS with 10 Hz
6 times/per week for 2 weeks, total 12 times rTMS.
6 times/per week for 2 weeks, total 12 times rTMS with 10 Hz.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes of International Cooperative Ataxia Rating Scale
Time Frame: Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
International Cooperative Ataxia Rating Scale (ICARS): quantify the level of impairment as a result of ataxia as related to hereditary ataxias. Disorders rated as subscales within the ICARS are: Postural and gait disturbances, Limb Ataxia, Dysarthria, and Oculomotor disorders.It translates the symptomatology of cerebellar ataxia into a scoring system out of 100.
Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Changes of SARA
Time Frame: Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Scale for the Assessment and Rating of Ataxia (SARA): a tool for assessing ataxia. It has eight categories with accumulative score ranging from 0 (no ataxia) to 40 (most severe ataxia).
Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Changes of Berg Balance Scale
Time Frame: Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Berg Balance Scale (BBS): a widely used assessment to determine a person's balance abilities. The test contains 14 simple tasks, scoring ranges from 0 to 56. The lower your score, the more at risk you are for losing your balance. The entire process takes about 20 minutes to complete.
Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Changes of Timed up and go
Time Frame: Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Timed up and go (TUG): Patients wear their regular footwear and can use a walking aid, if needed. Begin by having the patient sit back in a standard arm chair and identify a line 3 meters, or 10 feet away, on the floor.
Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Changes of Center of pressure trajectory
Time Frame: Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Center of pressure (COP): he trajectory of the COP, commonly known as a stabilogram, during static balance is frequently used to measure postural control. When standing still on a force platform, the COP is thought to be an indicator of the motor mechanisms involved in maintaining balance with opened-eyes or closed-eyes. Two trials for each condition were performed within 5 minutes.
Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Changes of Kinematic of Gait
Time Frame: Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
The joint angles of hip, knee, ankle are collected during walking in a 10 meters walkway.
Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
Changes of Electromyography of Gait
Time Frame: Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),
A wireless surface Electromyography (EMG) is used to collect lower extremities muscle activation signals during walking in a walkway.
Baseline (T0), 6 days after first rTMS intervention (T1), 12 days after first rTMS intervention (T2),

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Concentration of Neurofilament
Time Frame: Baseline (T0), 12 days after first rTMS intervention (T2)
neurofilament proteins is the biomarkers of axonal damage in diseases affecting the central nervous system
Baseline (T0), 12 days after first rTMS intervention (T2)
Changes of Mini-mental state examination
Time Frame: Baseline (T0)
The mini-mental state examination (MMSE) is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment. A score of 25 or higher is classed as normal. If the score is below 24, the result is usually considered to be abnormal, indicating possible cognitive impairment. In this study, it is used to rule out subjects who might have dementia.
Baseline (T0)

Collaborators and Investigators

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

Sponsor

Investigators

  • Principal Investigator: Sen Yung Liu, MD, Changhua Christian Hospital

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, 2023

Primary Completion (Estimated)

June 30, 2024

Study Completion (Estimated)

August 1, 2024

Study Registration Dates

First Submitted

July 25, 2023

First Submitted That Met QC Criteria

July 25, 2023

First Posted (Actual)

August 2, 2023

Study Record Updates

Last Update Posted (Actual)

October 18, 2023

Last Update Submitted That Met QC Criteria

October 16, 2023

Last Verified

October 1, 2023

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 230425

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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