Transcranial Static Magnetic Stimulation (tSMS) and Potential Theranostic Biomarkers in Amyotrophic Lateral Sclerosis.
Efficacy of Transcranial Static Magnetic Field Stimulation (tSMS) and Potential Theranostic Biomarkers in Amyotrophic Lateral Sclerosis (ALS).
The objective of the present study is to assess the efficacy of tSMS in ALS patients. This will be achieved by monitoring:
- levels of NF-L and other potential innovative biomarkers,
- clinical progression, trough ALSFRS-R. After at least three-month follow-up, participants will be recruited to undergo biemispheric tSMS for two daily sessions of 120 minutes each, at home, for 12 months. Together with clinical status, which will be evalueted each three months, blood and urine samples will be collected before the start of the tSMS administration (M0) and during the treatment (M3, M6, M9, M12), to detect potential theranostic biomarkers. In a subgroup of patients, ad additional blood and urine sample will be collected 3 months before M0 (M-3).
Moreover, cortical excitability will be tested through transcranial magnetic stimulation (TMS) before and after the tSMS stimulation period.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Vincenzo Di Lazzaro
- Phone Number: 06 22541 1220
- Email: v.dilazzaro@policlinicocampus.it
Study Locations
-
-
RM
-
Roma, RM, Italy, 00128
- Fondazione Policlinico Campus Bio-Medico
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- age ≥ 18
- diagnosis of possible, probable or definite ALS according to revised El Escorial criteria and Awaji-Shima criteria
- disease duration < 24 months
- ALSFRS-R > 30 at the recruitment
- ALSFRS-R decline > 1 in the at least 3-months period before the intervention
- normal respiratory functionality at the preliminary evaluation (M-3), assessed in the previous month (FVC ≥ 75% and ALSFRS-R items 10,11,12 > 4)
- treatment with riluzole 50 mg x 2/die
Exclusion Criteria:
- inclusion in other clinical trials
- presence of tracheotomy or/and PEG (percutaneous endoscopic gastrostomy)
- unable to perform spirometry due to severe bulbar involvement
- contraindications to magnetic fields exposure
- pregnancy or breastfeeding
- history of epilepsy or seizures
- use of drugs acting on central nervous system, except for antidepressive drugs and benzodiazepines.
- cognitive impairment
- lack of informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: pwALS
All participants will undergo tSMS administration at home, in two daily sessions of 120 minutes each.
|
Transcranial static magnetic stimulation (tSMS) will be delivered simultaneously to both hemispheres, at the motor cortex (M1), via magnets housed in a helmet.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
NfL reduction
Time Frame: 12 months
|
The potential reduction of NfL during treatment is monitored by blood samples collected at baseline, and then , every 3 months during the treatment
|
12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Monthly Progression Rate (MPR)
Time Frame: 15 months
|
MPR is derived from the comparison between the ALSFRS-R (Revised Amyotrophic Lateral Sclerosis Functional Rating Scale) decline over the period of at least three months before the treatment, and the period of twelve months during the treatment.
The ALSFRS-R is 12-items scale ranking from 0 (worse) to 48 (better) points.
|
15 months
|
|
Effect on resting motor threshold (RMT) and active motor threshold (AMT)
Time Frame: 12 months
|
Change in TMS-derived cortical excitability parameters (RMT and AMT) before and after stimulation period.
|
12 months
|
|
Effect on motor evoked potentials (MEP) size
Time Frame: 12 months
|
Change in TMS-derived cortical excitability parameters (MEP size) before and after stimulation period.
|
12 months
|
|
New Potential Theranostic Biomarkers Assay
Time Frame: 12 months
|
Investigation of potential theranostic biomarkers in blood samples (YKL-40, TDP43) and urine samples (p75ECD), collected at baseline and evrey three months during the treatment
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Central Nervous System Diseases
- Nervous System Diseases
- Neuromuscular Diseases
- Metabolic Diseases
- Neurodegenerative Diseases
- Spinal Cord Diseases
- TDP-43 Proteinopathies
- Proteostasis Deficiencies
- Motor Neuron Disease
- Nutritional and Metabolic Diseases
- Amyotrophic Lateral Sclerosis
- Therapeutics
- Magnetic Field Therapy
- Transcranial Magnetic Stimulation
Other Study ID Numbers
Other Study ID Numbers
- StaticALS
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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