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- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT07738432
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)
Panoramica dello studio
Stato
Condizioni
Descrizione dettagliata
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 di studio
Iscrizione (Stimato)
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
- Nome: Bernadette Gillick, PhD, MSPT
- Numero di telefono: 608-262-7457
- Email: bgillick@wisc.edu
Backup dei contatti dello studio
- Nome: Arun Karumattu Manattu, PhD
- Numero di telefono: 608-381-2699
- Email: karumattuman@wisc.edu
Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Bambino
Accetta volontari sani
Descrizione
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
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: N / A
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
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Sperimentale: 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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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Proportion of participants in whom MEPs can be elicited reliably at baseline (presence/absence)
Lasso di tempo: 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
Lasso di tempo: 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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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Baseline MEP Amplitude
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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)
Lasso di tempo: 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)
Lasso di tempo: 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)
Lasso di tempo: 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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Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
MEP Amplitude
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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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Collaboratori e investigatori
Sponsor
Investigatori
- Investigatore principale: Bernadette Gillick, PhD, MSPT, UW School of Medicine and Public Health
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Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
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Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
- emorragia intracranica
- ictus perinatale
- Terapia del movimento indotta da vincoli (CIMT)
- stimolazione nervosa vago auricolare transcutaneo (TAVNS)
- hypoxic-ischemic encephalopathy (HIE)
- hemiplegic cerebral palsy (CP)
- motor-evoked potentials (MEPs)
- Single Pulse Transcranial Magnetic Stimulation (spTMS)
Termini MeSH pertinenti aggiuntivi
- Disturbi cerebrovascolari
- Malattie del cervello
- Malattie del sistema nervoso centrale
- Malattie del sistema nervoso
- Malattie vascolari
- Malattia cardiovascolare
- Processi patologici
- Emorragia
- Ischemia cerebrale
- Segni e sintomi, respiratori
- Ipossia, cervello
- Ipossia
- Condizioni patologiche, segni e sintomi
- Segni e sintomi
- Ipossia-ischemia, cervello
- Emorragie intracraniche
- Terapie
- Modalità di terapia fisica
- Terapia di esercizio
- Riabilitazione
- Terapia del Movimento Indotta da Vincoli
Altri numeri di identificazione dello studio
- 2026-0790
- ICTR Pilot Award (Altro numero di sovvenzione/finanziamento: NCATS)
- Protocol Version 6/17/26 (Altro identificatore: UW Madison)
- SMPH/Pediatrics/Dev & Reh Med (Altro identificatore: UW Madison)
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