- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT05196178
Spinal Cord Stimulation Therapy for Hereditary Spastic Paraplegias Patients
Effects of Spinal Cord Stimulation Therapy on Motor Function and Gait in Patients With Pure Hereditary Spastic Paraplegias
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
Pure hereditary spastic paraplegia is a heterogeneous group of genetic disorders characterized by degeneration of the corticospinal tracts, coursing with progressive weakness and spasticity of the lower limbs. The available anti spastic agents and surgical procedures involving anti-spastic systemic drugs, botulinum toxin, intrathecal baclofen, and even selective dorsal rhizotomy have not shown an improvement in muscle strength. Physical rehabilitation alone has shown positive results in short term, but this effect tends to fade away in few months.To date, there are no effective treatments for progressive deficits or disease-modifying therapy for Hereditary spastic paraplegia patients,
Spinal cord stimulation is a wellestablished therapy for the treatment of chronic neuropathic pain. Recently, some pilot studies demonstrated encouraging results of SCS in improving motor function. Patients severely affected by spinal cord injury experienced enhancements in leg movements and Parkinson's disease, primary progressive freezing of gait, and multiple system atrophy with predominant parkinsonism patients improved gait performance and freezing of gait after spinal cord stimulation by inducing changes in spinal and brain circuitry function. Some case studies suggest spinal cord stimulation may delay motor worsening and be innovative lines of research for the treatment of spastic paraplegia. However, evidence from larger numbers of subjects is still lacking. The objective of this study is to investigate the therapeutic effect and safety of spinal cord stimulation on motor function and gait in patients with pure hereditary spastic paraplegias
It's a single-center, prospective, open label clinical study with a 12 months follow- up period. The intended study population is individuals suffering from pure hereditary spastic paraplegia.Each participant will complete an enrollment/ screening/baseline visit, a spinal cord stimulation implant and activation visit, and a minimum of two follow-up visits, including visit at 3 months and the final study visit at 12months. The participants will proceed to implantation after satisfying implant inclusion and exclusion criteria. Paddle-shaped Spinal cord stimulation electrode with 16 contacts ((AdaptiveStim 39, 565; Medtronic, Minneapolis, USA) will be implanted into the epidural space at the thoracic levels ranging from T10 to T12. Electrode position will be verified by X-ray. The stimulators will be turned on within 1 month after electrode implantation surgery (slightly below sensory threshold). The stimulation parameters could vary freely, but medications will be kept constant during the study period. At the end of month 12, participants will enter the long-term follow-up in which medications and stimulation parameters could vary freely.
Tipo de estudio
Inscripción (Anticipado)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
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Beijing
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Beijing, Beijing, Porcelana, 100053
- Reclutamiento
- Xuanwu Hospital,Capital Medical University
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-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- aged between 14 and 70 years
- patients with pure hereditary spastic paraplegias
- with progressive weakness and spasticity of the lower limbs, and the gait dysfunction treatable by medication but not adequately controlled with medications
- Understand potential risk/benefit, consent to the study, study procedures, and agree to complete the study follow-up visits and comply with the study protocol requirements.
Exclusion Criteria:
- cognitive impairment ( MMSE≤24), depression (HAMD>24),acute psychosis, active alcohol or drug abuse, terminal illness, and any major medical or psychological histories, diagnoses, conditions, or comorbidities that would interfere with participation in the study per the investigatior's medical judgment
- surgical or medical contraindications to spinal cord stimulation surgery(e.g. uncontrolled hypertension, advanced coronary artery disease).
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)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Experimental: Spinal cord stimulation therapy
Spinal cord stimulation at the thoracic levels ranging from T10 to T12.
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Paddle-shaped Spinal cord stimulation electrode with 16 contacts (AdaptiveStim® 39, 565;Medtronic, USA) will be implanted into the epidural space at the thoracic levels ranging from T10 to T12.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
change in spastic paraplegia rating scale(SPRS)
Periodo de tiempo: twelve months after surgery
|
demonstrate the statistically significant improvement in score of spastic paraplegia rating scale(SPRS) from baseline( Off medication) to 12 months(On stimulation/Off medication); The score of SPRS ranges from 0 to 52, higher scores mean a worse outcome .
|
twelve months after surgery
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
change in the score of Modified Ashworth Scale
Periodo de tiempo: twelve months after surgery
|
demonstrate statistically significant improvement in score of Modified Ashworth Scale from baseline( Off medication) to 12 months(On stimulation/Off medication); The score of Modified Ashworth Scale ranges from 0 to 4, higher scores mean a worse outcome.
|
twelve months after surgery
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change in Activities of Daily Living Scale (ADL)
Periodo de tiempo: twelve months after surgery
|
demonstrate statistically significant improvement in score of Activities of Daily Living Scale (ADL) from baseline to 12 months.
The score of ADL ranges from 0 to 100, higher scores mean a better outcome.
|
twelve months after surgery
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change in Tinetti Balance and Gait Analysis
Periodo de tiempo: twelve months after surgery
|
demonstrate statistically significant improvement in the score of Tinetti balance and gait analysis from baseline( Off medication) to 12 months(On stimulation/Off medication); The score of Tinetti balance and gait ranges from 0 to 28, higher scores mean a better outcome.
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twelve months after surgery
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change in Berg Balance Scale(BBS)
Periodo de tiempo: twelve months after surgery
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demonstrate statistically significant improvement in score of Berg Balance Scale(BBS) from baseline( Off medication) to On stimulation/Off medication state at 12 months.
BBS ranged from 0 to 56, higher scores mean a better outcome.
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twelve months after surgery
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Clinical Global Impression-Global Improvement
Periodo de tiempo: twelve months after surgery
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Evaluations will performed in off-stimulation and in on-stimulation conditions at 12 months after surgery on the basis of the physician's assessment, as well as on the basis of the patients'selfreported satisfaction.
It is rated on a 7-point scale, range from 1(very much improved) through to 7 (very much worse)
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twelve months after surgery
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Yuqing Zhang, MD, Xuanwu Hospital, Beijing
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Finalización primaria (Anticipado)
Finalización del estudio (Anticipado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
- Enfermedades del Sistema Nervioso
- Manifestaciones neurológicas
- Anomalías congénitas
- Enfermedades Genéticas Congénitas
- Enfermedades musculoesqueléticas
- Enfermedades Musculares
- Enfermedades Neuromusculares
- Enfermedades neurodegenerativas
- Enfermedades del Sistema Nervioso Periférico
- Manifestaciones Neuromusculares
- Trastornos Heredodegenerativos, Sistema Nervioso
- Malformaciones del Sistema Nervioso
- Parálisis
- Hipertonía muscular
- Polineuropatías
- Neuropatía sensorial y motora hereditaria
- Espasticidad muscular
- Paraplejía
- Paraplejía Espástica, Hereditaria
Otros números de identificación del estudio
- 20211116
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
producto fabricado y exportado desde los EE. UU.
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