Safety and Effectiveness of Cortical Stimulation in the Treatment of Stroke Patients With Upper Extremity Hemiparesis

NCT ID: NCT00170716

Last Updated: 2007-12-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

174 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-09-30

Study Completion Date

2008-03-31

Brief Summary

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The purpose of this study is to assess the safety and effectiveness of cortical stimulation delivered concurrent with rehabilitation activities to enhance motor recovery in patients suffering from hemiparesis affecting the upper extremity following a stroke.

Detailed Description

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Stroke is a leading cause of serious, long-term disability in the United States. According to the American Stroke Association, the prevalence of stroke in the U.S. is approximately 4.8 million with approximately 700,000 additional strokes occurring annually. The 2001 overall death rate for stroke was 58%. Of those who survive, 30 to 50 percent do not regain functional independence, 15 to 30 percent are permanently disabled, and 20% require institutional care at three months after onset.

The most common neurological deficit among these stroke survivors, and thus a substantial contributor to post-stroke disability, is a motor weakness on one (hemiparesis) side of the body. Presently, the only treatment available for patients with motor deficits is rehabilitative therapy. However, many patients are not responsive to standard rehabilitative therapy or achieve a less than satisfactory improvement in function.

The primary objective of this study is to determine the safety and effectiveness of targeted sub-threshold epidural cortical stimulation delivered concurrent with rehabilitation activities to enhance motor recovery in patients suffering from hemiparesis (a motor weakness in one half of the body) affecting the upper extremity (shoulder, arm, wrist, hand) following a stroke. In addition to evaluating changes from baseline level, safety and efficacy measures will be compared to patients who undergo the same rehabilitation activities but without cortical stimulation. The two study groups will be compared to determine the degree to which motor function of the affected limb can be improved beyond rehabilitation alone by epidural stimulation of a targeted cortical region.

Conditions

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Stroke Hemiparesis

Keywords

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Motor Cortex Electrical Stimulation Ischemic Stroke Upper Extremity Hemiparesis Rehabilitation Motor Recovery Functional MRI

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Control

Group Type ACTIVE_COMPARATOR

Rehabilitation

Intervention Type OTHER

Rehabilitation is for 2.5 hrs per day for 26 days over a period of 6 weeks.

Investigational

Group Type EXPERIMENTAL

Cortical Stimulation and rehabilitation

Intervention Type DEVICE

Cortical stimulation is provided concomitantly with rehabilitation therapy. Rehabilitation is for 2.5 hrs per day for 26 days over a period of 6 weeks.

Interventions

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Cortical Stimulation and rehabilitation

Cortical stimulation is provided concomitantly with rehabilitation therapy. Rehabilitation is for 2.5 hrs per day for 26 days over a period of 6 weeks.

Intervention Type DEVICE

Rehabilitation

Rehabilitation is for 2.5 hrs per day for 26 days over a period of 6 weeks.

Intervention Type OTHER

Other Intervention Names

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Renova-ST Cortical Stimulation System Post-stroke rehabilitation.

Eligibility Criteria

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Inclusion Criteria

* Subjects must have an ischemic stroke.
* Moderate to moderately severe upper-extremity hemiparesis.
* Aged 21 years or older.

Exclusion Criteria

* Primary hemorrhagic stroke.
* Any additional stroke associated with incomplete motor recovery.
* Any neurologic or physical condition impairing function of the target extremity.
* History of seizure disorder.
* History of spinal cord injury, traumatic brain injury, or spontaneous subdural or epidural hematoma that has resulted in a neurologic deficit.
* Contraindication to magnetic resonance (MR) imaging.
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Northstar Neuroscience

INDUSTRY

Sponsor Role lead

Responsible Party

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Northstar Neuroscience

Locations

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University of Arizona Health Sciences Center

Tucson, Arizona, United States

Site Status

University of Southern California

Los Angeles, California, United States

Site Status

University of California San Francisco Medical Center

San Francisco, California, United States

Site Status

Stanford University Medical Center

Stanford, California, United States

Site Status

Colorado Neurological Institute & Swedish Medical Center

Englewood, Colorado, United States

Site Status

University of Florida, Jacksonville

Jacksonville, Florida, United States

Site Status

Emory Clinic

Atlanta, Georgia, United States

Site Status

Northwestern University Medical Center and the Rehabilitation Institute of Chicago

Chicago, Illinois, United States

Site Status

University of Illinois at Chicago

Chicago, Illinois, United States

Site Status

Spaulding Rehabilitation Center and Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Wayne State University

Detroit, Michigan, United States

Site Status

St. Luke's Hospital

Kansas City, Missouri, United States

Site Status

Mount Sinai School of Medicine

New York, New York, United States

Site Status

State University of New York Upstate Medical Center

Syracuse, New York, United States

Site Status

University of Cincinnati Medical Center

Cincinnati, Ohio, United States

Site Status

Oregon Health Sciences University

Portland, Oregon, United States

Site Status

University of Pennsylvania Medical Center

Philadelphia, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States

Site Status

University of Texas Health Sciences Center at Houston

Houston, Texas, United States

Site Status

University of Utah Health Sciences Center

Salt Lake City, Utah, United States

Site Status

Swedish Health Services

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Brown JA, Lutsep H, Cramer SC, Weinand M. Motor cortex stimulation for enhancement of recovery after stroke: case report. Neurol Res. 2003 Dec;25(8):815-8. doi: 10.1179/016164103771953907.

Reference Type BACKGROUND
PMID: 14669524 (View on PubMed)

Cramer SC, Benson RR, Himes DM, Burra VC, Janowsky JS, Weinand ME, Brown JA, Lutsep HL. Use of functional MRI to guide decisions in a clinical stroke trial. Stroke. 2005 May;36(5):e50-2. doi: 10.1161/01.STR.0000163109.67851.a0. Epub 2005 Apr 14.

Reference Type BACKGROUND
PMID: 15831835 (View on PubMed)

Brown JA, Lutsep HL, Weinand M, Cramer SC. Motor cortex stimulation for the enhancement of recovery from stroke: a prospective, multicenter safety study. Neurosurgery. 2006 Mar;58(3):464-73. doi: 10.1227/01.NEU.0000197100.63931.04.

Reference Type BACKGROUND
PMID: 16528186 (View on PubMed)

Levy RM, Harvey RL, Kissela BM, Winstein CJ, Lutsep HL, Parrish TB, Cramer SC, Venkatesan L. Epidural Electrical Stimulation for Stroke Rehabilitation: Results of the Prospective, Multicenter, Randomized, Single-Blinded Everest Trial. Neurorehabil Neural Repair. 2016 Feb;30(2):107-19. doi: 10.1177/1545968315575613. Epub 2015 Mar 6.

Reference Type DERIVED
PMID: 25748452 (View on PubMed)

Related Links

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Other Identifiers

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V0267

Identifier Type: -

Identifier Source: org_study_id