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Neuro-MoD: Neuroplasticity With Motor Development

2026年9月11日 更新者：University of Wisconsin, Madison

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)

This study is for infants and toddlers between 8 and 24 months old who use one arm and/or hand differently following a perinatal brain injury. This is a time when investigators think they can best help improve how the brain controls movement. Investigators are testing whether the combination of transcutaneous auricular vagus nerve stimulation (taVNS) with 40 hours of constraint-induced movement therapy (CIMT) can help infants move their weaker arm and hand better and make the brain pathways for movement stronger.

調査の概要

状態

まだ募集していません

条件

介入・治療

詳細な説明

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.

研究の種類

介入

入学 (推定)

8

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

  • 名前：Bernadette Gillick, PhD, MSPT
  • 電話番号：608-262-7457
  • メール：bgillick@wisc.edu

研究連絡先のバックアップ

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 子

健康ボランティアの受け入れ

いいえ

説明

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

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：処理
  • 割り当て：なし
  • 介入モデル：単一グループの割り当て
  • マスキング：なし（オープンラベル）

武器と介入

参加者グループ / アーム
介入・治療
実験的：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.
行動：Constraint-Induced Movement Therapy (CIMT)
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.
デバイス：Transcutaneous auricular vagus nerve stimulation (taVNS)
Stimulates a nerve by the ear, called the vagus nerve, that may enhance learning motor skills.

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Proportion of participants in whom MEPs can be elicited reliably at baseline (presence/absence)
時間枠：baseline (Day 1)
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.
baseline (Day 1)
Completion rate of spTMS sessions
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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.
baseline (Day 1), post-intervention (Day 12), 3 month follow-up

二次結果の測定

結果測定
メジャーの説明
時間枠
Baseline MEP Amplitude
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up
MEP amplitude will be reported in millivolts (mV), measured from electromyography recordings of the target muscle.
baseline (Day 1), post-intervention (Day 12), 3 month follow-up
Percent change in Mini-Assisting Hand Assessment (mini-AHA) score from baseline to end of treatment
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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.
baseline (Day 1), post-intervention (Day 12), 3 month follow-up
Change in Quality of Upper Extremity Skills Test (QUEST) score from baseline
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up

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
Bayley Scales of Infant Development (Bayley-4; Fine Motor subtest)
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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.
baseline (Day 1), post-intervention (Day 12), 3 month follow-up
Bayley Scales of Infant Development (Bayley-4; Gross Motor subtests)
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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.
baseline (Day 1), post-intervention (Day 12), 3 month follow-up
Gross Motor Function Measure (GMFM-88)
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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.
baseline (Day 1), post-intervention (Day 12), 3 month follow-up

その他の成果指標

結果測定
メジャーの説明
時間枠
MEP Amplitude
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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).
baseline (Day 1), post-intervention (Day 12), 3 month follow-up
MEP Threshold
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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).
baseline (Day 1), post-intervention (Day 12), 3 month follow-up
Cortical Map Topography
時間枠：baseline (Day 1), post-intervention (Day 12), 3 month follow-up
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.
baseline (Day 1), post-intervention (Day 12), 3 month follow-up

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

University of Wisconsin, Madison

捜査官

  • 主任研究者：Bernadette Gillick, PhD, MSPT、UW School of Medicine and Public Health

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年10月1日

一次修了 (推定)

2027年6月1日

研究の完了 (推定)

2027年6月1日

試験登録日

最初に提出

2026年7月27日

QC基準を満たした最初の提出物

2026年7月27日

最初の投稿 (実際)

2026年7月31日

学習記録の更新

投稿された最後の更新 (実際)

2026年9月14日

QC基準を満たした最後の更新が送信されました

2026年9月11日

最終確認日

2026年7月1日

詳しくは

本研究に関する用語

キーワード

追加の関連 MeSH 用語

その他の研究ID番号

  • 2026-0790
  • ICTR Pilot Award (その他の助成金/資金番号：NCATS)
  • Protocol Version 6/17/26 (その他の識別子：UW Madison)
  • SMPH/Pediatrics/Dev & Reh Med (その他の識別子：UW Madison)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

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いいえ

米国FDA規制機器製品の研究

はい

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はい

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