Neuro-MoD: Neuroplasticity With Motor Development
Harnessing Early Neuroplasticity in Infants With Perinatal Brain Injury: A Study of Combined Transcutaneous Auricular Vagal Nerve Stimulation (taVNS) Paired With Constraint Induced Movement Therapy (CIMT) and Transcranial Magnetic Stimulation (TMS)
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
Primary Objective • To evaluate the feasibility of using spTMS to elicit motor-evoked potentials (MEPs) in infants with hemiplegic cerebral palsy (CP) due to perinatal brain injury and to determine whether baseline MEP characteristics predict motor response to a 40-hour intervention combining taVNS with CIMT.
Exploratory Objective:
• To investigate neuroplastic changes in cortical motor circuitry associated with taVNS-paired CIMT by examining longitudinal changes in MEP topography and corresponding motor function.
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Bernadette Gillick, PhD, MSPT
- Número de teléfono: 608-262-7457
- Correo electrónico: bgillick@wisc.edu
Copia de seguridad de contactos de estudio
- Nombre: Arun Karumattu Manattu, PhD
- Número de teléfono: 608-381-2699
- Correo electrónico: karumattuman@wisc.edu
Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
- Niño
Acepta Voluntarios Saludables
Descripción
Inclusion Criteria:
- Infants aged 8 to 24 months, diagnosed with hemiplegia or with an evident unilateral upper-limb weakness due to perinatal brain injury
- Gross Motor Function Classification System (GMFCS) level I-IV
- Infants who have not received previous CIMT in the preceding 3 months
- Able to make consecutive appointments for assessments and intervention over 2 weeks, and complete the 3-month follow-up.
Exclusion Criteria:
- GMFCS level V
- Prior CIMT within the past 3 months
- Severe motor impairment/quadriplegic involvement.
- Uncontrolled seizure disorders, cardiomyopathy, severe congenital malformations,
- significant sensory impairments, or conditions preventing safe participation in therapy sessions
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: N / A
- Modelo Intervencionista: Asignación de un solo grupo
- Enmascaramiento: Ninguno (etiqueta abierta)
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
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Experimental: Infants and Toddlers with Perinatal Brain Injury
Therapy sessions in this study will take 4 hours a day, 5 days a week for 2 weeks (40 hours total CIMT).
Sticker like sensors (electrodes) are placed just inside and outside the child's left earlobe at the start of the session to deliver the taVNS.
During daily therapy sessions, the taVNS will be on whenever the child moves their free arm, for up to 2.5 minutes at a time.
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CIMT involves placing a mitt constraint on the stronger arm and hand while encouraging your child to use the weaker arm and hand during intensive therapy sessions.
Stimulates a nerve by the ear, called the vagus nerve, that may enhance learning motor skills.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Proportion of participants in whom MEPs can be elicited reliably at baseline (presence/absence)
Periodo de tiempo: baseline (Day 1)
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Motor-evoked potentials (MEPs) are electrical responses recorded from a muscle following a brief magnetic pulse delivered to the brain using single-pulse transcranial magnetic stimulation (spTMS).
This outcome measures the proportion of participants in whom a reliable MEP can be elicited at baseline and serves as a measure of the feasibility of assessing corticospinal connectivity in infants with perinatal brain injury.
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baseline (Day 1)
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Completion rate of spTMS sessions
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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This outcome measures the proportion of planned spTMS assessment sessions that are successfully completed at baseline, post-intervention, and 3-month follow-up.
Completion rates will be used to evaluate the feasibility, tolerability, and practicality of conducting repeated spTMS assessments in infants and toddlers with perinatal brain injury.
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baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Baseline MEP Amplitude
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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MEP amplitude will be reported in millivolts (mV), measured from electromyography recordings of the target muscle.
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baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Percent change in Mini-Assisting Hand Assessment (mini-AHA) score from baseline to end of treatment
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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The mini-AHA evaluates how effectively infants with unilateral upper extremity impairment use their affected hand during bimanual play activities.
Scores are reported on a standardized 0-100 scale, with higher scores indicating greater functional use of the affected hand and lower scores indicating less functional use.
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baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Change in Quality of Upper Extremity Skills Test (QUEST) score from baseline
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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This is a measure of movement, scored in several domains: dissociated movement (joint mobility), grasp (holding and manipulating objects), protective extension (reflex reactions), and weight bearing assessments. It is scored from 0 to 100 where higher scores mean better movement. Change in QUEST score from baseline will be used to assess changes in upper extremity function following the intervention. |
baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Bayley Scales of Infant Development (Bayley-4; Fine Motor subtest)
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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The Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4) Fine Motor subtest evaluates fine motor skills, including reaching, grasping, object manipulation, and hand-eye coordination.
Scores are standardized based on age and range from 1 to 19, with a normative mean of 10 and standard deviation of 3. Scores in the range of 8-12 are generally considered within the typical range for age.
Higher scores indicate more advanced motor development.
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baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Bayley Scales of Infant Development (Bayley-4; Gross Motor subtests)
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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The Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4) Gross Motor subtest evaluates gross motor skills, including posture, sitting, crawling, standing, walking, and other age-appropriate movement abilities.
Scores are standardized based on age and range from 1 to 19, with a normative mean of 10 and standard deviation of 3. Scores in the range of 8-12 are generally considered within the typical range for age.
Higher scores indicate more advanced motor development.
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baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Gross Motor Function Measure (GMFM-88)
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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The Gross Motor Function Measure-88 (GMFM-88) evaluates gross motor function across five domains: lying and rolling, sitting, crawling and kneeling, standing, and walking, running, and jumping.
Items are scored on a 4-point scale and converted to dimension and total scores ranging from 0 to 100.
Higher scores indicate better gross motor function and greater ability to perform age-appropriate motor activities.
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baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Otras medidas de resultado
Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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MEP Amplitude
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Motor-evoked potential (MEP) amplitude measures the strength of the muscle response produced after a brief magnetic pulse is applied to the brain using single-pulse transcranial magnetic stimulation (spTMS).
Larger amplitudes indicate stronger communication between the brain and the target muscle.
MEP amplitude will be reported in millivolts (mV).
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baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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MEP Threshold
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Motor-evoked potential (MEP) threshold is the minimum level of magnetic stimulation needed to produce a muscle response.
Lower thresholds generally indicate that the pathway between the brain and muscle can be activated more easily.
MEP threshold will be reported as a percentage of maximum stimulator output (%MSO).
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baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Cortical Map Topography
Periodo de tiempo: baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Cortical map topography describes the location and distribution of brain areas that produce muscle responses when stimulated using single-pulse transcranial magnetic stimulation (spTMS).
Changes in the size, location, or organization of these areas over time may reflect changes in brain connectivity and neuroplasticity.
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baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Bernadette Gillick, PhD, MSPT, UW School of Medicine and Public Health
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
- hemorragia intracraneal
- accidente cerebrovascular perinatal
- Terapia de movimiento inducida por restricciones (CIMT)
- Estimulación del nervio auricular auricular transcutáneo (TAVN)
- hypoxic-ischemic encephalopathy (HIE)
- hemiplegic cerebral palsy (CP)
- motor-evoked potentials (MEPs)
- Single Pulse Transcranial Magnetic Stimulation (spTMS)
Términos MeSH relevantes adicionales
- Trastornos cerebrovasculares
- Enfermedades Cerebrales
- Enfermedades del Sistema Nervioso Central
- Enfermedades del Sistema Nervioso
- Enfermedades Vasculares
- Enfermedades cardiovasculares
- Procesos Patológicos
- Hemorragia
- Isquemia cerebral
- Signos y Síntomas Respiratorios
- Hipoxia, Cerebro
- Hipoxia
- Condiciones Patológicas, Signos y Síntomas
- Signos y síntomas
- Hipoxia-Isquemia Cerebral
- Hemorragias intracraneales
- Terapéutica
- Modalidades de fisioterapia
- Terapia de ejercicio
- Rehabilitación
- Terapia de Movimiento Inducida por Restricción
Otros números de identificación del estudio
Otros números de identificación del estudio
- 2026-0790
- ICTR Pilot Award (Otro número de subvención/financiamiento: NCATS)
- Protocol Version 6/17/26 (Otro identificador: UW Madison)
- SMPH/Pediatrics/Dev & Reh Med (Otro identificador: UW Madison)
Plan de datos de participantes individuales (IPD)
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Información sobre medicamentos y dispositivos, documentos del estudio
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