- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT07642856
Individualized Neuro-Modulation Paired With Cerebellar Therapy (IMPACT)
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
Cerebellar damage causes debilitating ataxia affecting balance, coordination, speech, and cognition. Rehabilitation therapy is the main treatment for ataxia because pharmacological therapeutics are extremely limited. Non-invasive brain stimulation has shown promise in improving motor function and has an excellent safety profile. However, optimal stimulation sites and efficacy when combined with rehabilitation remain unclear.
We hypothesize that three weeks of intensive rehabilitation therapy paired with personalized transcranial direct current stimulation (tDCS) will produce greater functional improvements in people with cerebellar damage compared to therapy with sham stimulation.
This double-blind, randomized, sham-controlled trial will enroll participants with cerebellar damage. We will determine stimulation sites using multimodal neuroimaging and electric field modeling and then check their response to stimulation. If they show MRI response to stimulation and it is well-tolerated, they will be eligible to receive 30 hours of training (one hour, twice daily), with active or sham tDCS during one of the daily sessions Primary outcomes are the Scale for Assessment and Rating of Cerebellar Ataxia (SARA) and Patient-Reported Outcome Measure of Ataxia (PROM-Ataxia), assessed pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
This research addresses a critical gap in treatment options for cerebellar ataxia by testing whether personalized neuromodulation enhances rehabilitation outcomes.
Tipo de estudio
Inscripción (Estimado)
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
- Nombre: Anthony J Gonzalez, BS
- Número de teléfono: 443-923-2716
- Correo electrónico: gonzalezan@kennedykrieger.org
Copia de seguridad de contactos de estudio
- Nombre: Derek J Eversley, BS
- Número de teléfono: 443-923-2716
- Correo electrónico: eversley@kennedykrieger.org
Ubicaciones de estudio
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Maryland
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Baltimore, Maryland, Estados Unidos, 21205
- Reclutamiento
- Motion Analysis Lab in the Kennedy Krieger Institute
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Contacto:
- Anthony J Gonzalez, BS
- Número de teléfono: 443-923-2716
- Correo electrónico: gonzalezan@kennedykrieger.org
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Investigador principal:
- Amy J Bastian, PhD, PT
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
- Adulto Mayor
Acepta Voluntarios Saludables
Descripción
Inclusion Criteria:
- Age 18-75 years
- Males and Females
- Disorders that predominantly affect the cerebellum: damage from stroke, tumor or degeneration (genetic or non-genetic causes, congenital hypoplasia).
Exclusion Criteria:
- Diagnoses or impairments that interfere with task execution or data interpretation.
- Heart pacemaker or other MRI-incompatible implanted metal device
- Metallic foreign body in their eye or head
- Experience with severe claustrophobia
- Experience discomfort from the MRI scan, such as excessive heating of tattoos
- Seizures or history of seizure disorder
- Alcohol or substance use disorder (self-report)
- Diagnosed history of severe psychiatric disorder such as depression, schizophrenia (self-report)
- Metallic foreign body in their eye or head (except the mouth e.g. dental fillings)
- Specific medications: tricyclic anti-depressants or neuroleptic medication
- Any medical condition (including orthopedic, pain, cardiopulmonary or other) that limits safe participation in exercise training
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: Active stimulation combined with therapy.
Once a stimulation site is determined, subjects will receive 20 minutes of active tDCS stimulation daily.
Subjects will also receive one hour of therapy, twice daily.
Therapy will be individualized to each subject and, will encompass three domains; 1) walking and balance control, 2) hand dexterity and arm control, 3)speech articulation, prosody, and intelligibility.
Subjects will complete up to 30 therapy sessions.
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Each participant will choose a domain that they would like to focus on.
Choices are: 1) walking and balance control, 2) hand dexterity and arm control, or 3) speech articulation, prosody, and intelligibility.
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Comparador falso: Sham stimulation combined with therapy.
Once a stimulation site is determined, subjects will receive 20 minutes of sham tDCS stimulation daily.
Subjects will also receive one hour of therapy, twice daily.
Therapy will be individualized to each subject and, will encompass three domains; 1) walking and balance control, 2) hand dexterity and arm control, 3)speech articulation, prosody, and intelligibility.
Subjects will complete up to 30 therapy sessions.
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Each participant will choose a domain that they would like to focus on.
Choices are: 1) walking and balance control, 2) hand dexterity and arm control, or 3) speech articulation, prosody, and intelligibility.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Scale for the Assessment and Rating of Ataxia (SARA)
Periodo de tiempo: Assessed at pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
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The SARA is a tool for assessing ataxia.
SARA is an 8-item performance based scale, yielding a total score of 0 (no ataxia) to 40 (most severe ataxia).
The scores are based on patient performance of: gait, stance, sitting, speech disturbance, finger chase, nose-finger test, fast alternating hand movements, heel-shin slide.
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Assessed at pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
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Patient-Reported Outcome Measure of Ataxia
Periodo de tiempo: Assessed at pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
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The PROM-Ataxia is a self reported questionnaire used by researchers to evaluate the daily impact and progression of cerebellar ataxia directly from the patient's perspective.
The questionnaire encompasses 70 total items within 3 main domains: 1) Physical: Gait, manual dexterity, swallowing (dysphagia), and visual/ocular motor control.
2) Activities of Daily Living (ADL): Managing household chores, employment, driving, and self-care.
3)Mental: Mood, anxiety, motivation, and cognitive tasks (e.g., multitasking and comprehension).
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Assessed at pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
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Colaboradores e Investigadores
Colaboradores
Investigadores
- Investigador principal: Amy J Bastian, PhD, PT, Motion Analysis Lab in the Kennedy Krieger Institute
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Finalización primaria (Estimado)
Finalización del estudio (Estimado)
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
Palabras clave
Términos MeSH relevantes adicionales
- Manifestaciones neurológicas
- Enfermedades Cerebrales
- Enfermedades del Sistema Nervioso Central
- Enfermedades del Sistema Nervioso
- Neoplasias por sitio
- Neoplasias
- Neoplasias del Sistema Nervioso
- Neoplasias del Sistema Nervioso Central
- Discinesias
- Neoplasias Cerebrales
- Neoplasias Infratentoriales
- Ataxia
- Condiciones Patológicas, Signos y Síntomas
- Signos y síntomas
- Ataxia cerebelosa
- Neoplasias Cerebelosas
- Enfermedades del cerebelo
- Terapéutica
Otros números de identificación del estudio
- IRB00519286
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.
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