Lower Limb Function After Spinal Cord Injury

NCT ID: NCT02635893

Last Updated: 2021-07-01

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

257 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-06-21

Study Completion Date

2021-04-11

Brief Summary

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This is a randomized, experimental study that examines the physiology of central nervous system pathways contributing to the control of bilateral movements in individuals with spinal cord injuries and promotes the recovery of lower-limb motor function through the use of stimulation and locomotor training.

Detailed Description

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This study plans to examine plasticity in corticospinal synapses of lower-limb muscles. it has been demonstrated that plasticity elicited at corticospinal synapses in the spinal cord result in enhancements in electromyographic (EMG) and force activity in upper-limb muscles. The first step in this proposal is to determine if synaptic plasticity can be elicited in corticospinal projections targeting lower-limb muscles in humans with SCI.

We will also study methods to strengthen corticospinal plasticity to promote recovery of leg clearance during training. We will use two novel strategies to enhance plasticity in corticospinal synapses of lower-limb muscles after SCI: a). administration of an N-methyl-D-aspartate (NMDA) receptor agonist (i.e. D-cycloserine), and b). Combine NMDA-induced corticospinal plasticity with training (2D lower limb training and locomotor training. Corticospinal synaptic plasticity is thought to depend on activation of NMDA receptors and D-cycloserine enhances motor skill behaviors in animals and humans will be enhanced by NMDA-induced corticospinal plasticity. An important strength of this aim is the combination of training and strategies that aimed at enhancing the synaptic efficacy of residual corticospinal projections. Training effects on physiological pathways will be explored and correlated with locomotor function

Conditions

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Spinal Cord Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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D-Cycloserine/Placebo + Stimulation

Participant will be given a single dose of 100 mg of D-Cycloserine or placebo before receiving stimulation.

Group Type ACTIVE_COMPARATOR

D-Cycloserine

Intervention Type DRUG

100 mg of Seromycin by mouth will be administered

Placebo

Intervention Type DRUG

placebo pill will be administered instead of medication by mouth

Stimulation

Intervention Type OTHER

magnetic stimulation and electrical stimulation may be applied

Training+Med/Placebo+Stimulation

Participant will be given a single dose of 100 mg of D-Cycloserine or placebo before receiving stimulation followed by training.

Group Type ACTIVE_COMPARATOR

D-Cycloserine

Intervention Type DRUG

100 mg of Seromycin by mouth will be administered

Placebo

Intervention Type DRUG

placebo pill will be administered instead of medication by mouth

Training

Intervention Type OTHER

walking around a designated track at different speeds both forward and backward

Stimulation

Intervention Type OTHER

magnetic stimulation and electrical stimulation may be applied

Training+Med+Stimulation/Placebo Stim

Participant will be given a single dose of 100 mg of D-Cycloserine or placebo before receiving stimulation or placebo stimulation followed by training.

Group Type ACTIVE_COMPARATOR

D-Cycloserine

Intervention Type DRUG

100 mg of Seromycin by mouth will be administered

Training

Intervention Type OTHER

walking around a designated track at different speeds both forward and backward

Stimulation

Intervention Type OTHER

magnetic stimulation and electrical stimulation may be applied

Placebo Stimulation

Intervention Type OTHER

this is a fake stimulation that is administered but will be unknow to the subject.

Interventions

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D-Cycloserine

100 mg of Seromycin by mouth will be administered

Intervention Type DRUG

Placebo

placebo pill will be administered instead of medication by mouth

Intervention Type DRUG

Training

walking around a designated track at different speeds both forward and backward

Intervention Type OTHER

Stimulation

magnetic stimulation and electrical stimulation may be applied

Intervention Type OTHER

Placebo Stimulation

this is a fake stimulation that is administered but will be unknow to the subject.

Intervention Type OTHER

Other Intervention Names

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Seromycin Placebo Drug

Eligibility Criteria

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Inclusion Criteria

* Male and females between ages 18-85 years of age
* SCI ( ≥1 month of injury)
* ASIA A, B,C and D
* SCI above L5
* Able to perform a visible contraction with dorsiflexor and hip flexor muscles (allowing testing of largely impaired patients)
* Able to ambulate a few steps with or without an assistive device


* Male and females between ages 18-85 years of age
* Able to walk and complete lower-limb tests with both legs

Exclusion Criteria

* Uncontrolled medical problems including pulmonary, cardiovascular or orthopedic disease,
* Any debilitating disease prior to the SCI that caused exercise intolerance
* Premorbid, ongoing major depression or psychosis, altered cognitive status
* History of head injury or stroke,
* Metal plate in skull
* History of seizures
* Receiving drugs acting primarily on the central nervous system, which lower the seizure threshold such as antipsychotic drugs (chlorpromazine, clozapine) or tricyclic antidepressants.
* Pregnant females, and
* Ongoing cord compression or a syrinx in the spinal cord or who suffer from a spinal cord disease such as spinal stenosis, spina bifida or herniated cervical disk.


* Uncontrolled medical problems including pulmonary, cardiovascular or orthopedic disease,
* Any debilitating disease that causes exercise intolerance
* Premorbid, ongoing major depression or psychosis, altered cognitive status
* History of head injury or stroke,
* Metal plate in skull
* History of seizures
* Receiving drugs acting primarily on the central nervous system, which lower the seizure threshold such as antipsychotic drugs (chlorpromazine, clozapine) or tricyclic antidepressants.
* Pregnant females, and
* Ongoing cord compression or a syrinx in the spinal cord or who suffer from a spinal cord disease such as spinal stenosis, spina bifida or herniated cervical disk.
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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The Craig H. Neilsen Foundation

OTHER

Sponsor Role collaborator

Shirley Ryan AbilityLab

OTHER

Sponsor Role lead

Responsible Party

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Monica Perez

Chair Arms + Hands Lab

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Monica A Perez, PT, Phd

Role: PRINCIPAL_INVESTIGATOR

Shirley Ryan AbilityLab

Locations

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The Shirley Ryan Ability Lab

Chicago, Illinois, United States

Site Status

Countries

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United States

Other Identifiers

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20150605

Identifier Type: -

Identifier Source: org_study_id

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