- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT07642856
Individualized Neuro-Modulation Paired With Cerebellar Therapy (IMPACT)
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
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 estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Anthony J Gonzalez, BS
- Número de telefone: 443-923-2716
- E-mail: gonzalezan@kennedykrieger.org
Estude backup de contato
- Nome: Derek J Eversley, BS
- Número de telefone: 443-923-2716
- E-mail: eversley@kennedykrieger.org
Locais de estudo
-
-
Maryland
-
Baltimore, Maryland, Estados Unidos, 21205
- Recrutamento
- Motion Analysis Lab in the Kennedy Krieger Institute
-
Contato:
- Anthony J Gonzalez, BS
- Número de telefone: 443-923-2716
- E-mail: gonzalezan@kennedykrieger.org
-
Investigador principal:
- Amy J Bastian, PhD, PT
-
-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
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.
|
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.
|
|
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.
|
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.
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Scale for the Assessment and Rating of Ataxia (SARA)
Prazo: Assessed at pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
|
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.
|
Assessed at pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
|
|
Patient-Reported Outcome Measure of Ataxia
Prazo: Assessed at pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
|
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).
|
Assessed at pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
|
Colaboradores e Investigadores
Colaboradores
Investigadores
- Investigador principal: Amy J Bastian, PhD, PT, Motion Analysis Lab in the Kennedy Krieger Institute
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Manifestações Neurológicas
- Doenças Cerebrais
- Doenças do Sistema Nervoso Central
- Doenças do Sistema Nervoso
- Neoplasias por local
- Neoplasias
- Neoplasias do Sistema Nervoso
- Neoplasias do Sistema Nervoso Central
- Discinesias
- Neoplasias Cerebrais
- Neoplasias Infratentoriais
- Ataxia
- Condições Patológicas, Sinais e Sintomas
- Sinais e sintomas
- Ataxia Cerebelar
- Neoplasias Cerebelares
- Doenças Cerebelares
- Terapêutica
Outros números de identificação do estudo
- IRB00519286
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .