Plasticity of Grey and White Matter in Response to Motor Skill Training in Healthy Individuals and Those With Spinal Cord Injury

NCT ID: NCT02148887

Last Updated: 2018-07-11

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 51 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2014-02-28
• Study Completion Date: 2018-05-31

Brief Summary

We aim to investigate the effect of motor skill training of the upper and lower limbs on the function and structure of the CNS as measured by neuroimaging parameters sensitive to changes in tissue volume and density and the properties of myelin.

Detailed Description

Functional recovery following human spinal cord injury (SCI) remains frustratingly limited and the majority of patients are left with severe impairments. While rehabilitative training has been shown to improve clinical outcome following SCI and has a major effect on patients' quality of life, the neuronal mechanisms underpinning neurological and functional recovery are not well understood.

Until recently, degenerative changes in components of the CNS remote to a SCI were thought to occur slowly (over years) and correlate with the degree of disability. Using longitudinal MRI protocols we have shown that these structural changes in fact occur early and progress both at the cord and brain level according to a specific spatial and temporal pattern (Freund et al 2013). It is thought that these trauma-induced structural changes progress retrogradely along central motor nerve fibres of the myelinated corticospinal tract (CST) and this is accompanied over time by shrinkage of corticospinal projecting neuronal bodies. Crucially, patients with less atrophy throughout the CST were those with better clinical recovery at twelve months. Despite this significant recovery advantage in some patients, all participants showed irreversible tissue loss, potentially hindering further recovery. Using the neuroimaging biomarkers established in the previous study cited above, we now aim to assess whether specific and intensive motor learning through tasks for the upper and lower limb might slow or reverse the atrophy seen in the sensorimotor system.

Conditions

Investigating Spinal Atrophy in Patients With Spinal Injury

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

SCI patients with upper limb impairment - Upper limb training

No interventions assigned to this group

SCI patients with lower limb impairment - Lower limb training

No interventions assigned to this group

Healthy controls - Upper limb training

No interventions assigned to this group

Healthy controls - Lower limb training

No interventions assigned to this group

Healthy controls - No intervention

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

Patients:

• Injury to the spinal cord which leads to any neurological deficits
• able to provide Informed consent

Controls:

• able to provide informed consent

Exclusion Criteria

• Pregnancy
• MRI incompatible
• Neurologic or physiatric disorders

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Foundation Wings For Life

OTHER

Sponsor Role: collaborator

University of Zurich

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Universitätsklinik Balgrist

Zurich, , Switzerland

Countries

Switzerland

Other Identifiers

KEK-ZH-2013-0559/PB_2016-00624

Identifier Type: -

Identifier Source: org_study_id