Neuroablation Versus Neuromodulation Techniques for Treatment of Secondary Dystonia

NCT ID: NCT03347240

Last Updated: 2017-11-20

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

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-12-01

Study Completion Date

2016-12-31

Brief Summary

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The disability inflected by dystonia encouraged the development of many neurosurgical procedures.

This is a prospective study included 120 patients suffering from intractable secondary dystonia.

They were subjected to different neurosurgical treatments and were assessed through the follow up period

Detailed Description

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Background:

Secondary dystonia are the syndromes that have dystonic symptoms due to brain insult which can be associated with neonatal encephalopathy syndromes, trauma, vascular injury, infections, demyelinations, or hereditary disorders associated with neurodegenerative process. The disability inflected by dystonia encouraged the development of many neurosurgical procedures in order to improve the quality of life of these patients.

The aim of this study was to compare the outcomes of different Neuroablative and modulation techniques in treatment of secondary dystonia.

Patients and methods This is a prospective study included 120 patients suffering from intractable secondary dystonia. Ablative techniques included the brain lesioning procedure and combined anterior and posterior lumbar rhizotomy (CAPR). Modulation techniques included deep brain stimulation (DBS) and intrathecal baclofen therapy (ITB). Patients with focal dystonia were included in the Botulinum toxin injection group. Patients with generalized dystonia were included in either of the brain lesioning or the deep brain stimulation, and patients with predominant affection of both lower limbs were included in either of the (CAPR) or the (ITB) groups.

Assessment measures included the evaluation of the muscle tone, range of motion, and the Burke-Fahn-Marsden dystonia rating scale through a follow up period of one year.

Conditions

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Secondary Dystonia

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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Brain lesioning group

Stereotactic lesioning of the thalamus or gloves pallidus

Group Type ACTIVE_COMPARATOR

Brain Lesioning

Intervention Type PROCEDURE

Stereotactic radiofrequency lesioning of the pallidum or thalamus

Combined rhizotomy group

Combined anterior and posterior lumbosacral rhizotomy

Group Type ACTIVE_COMPARATOR

Combined anterior and posterior lumbosacral rhizotomy

Intervention Type PROCEDURE

Combined anterior and posterior lumbosacral rhizotomy

Deep brain stimulation group

Bilateral globus pallidus internus deep brain stimulation

Group Type ACTIVE_COMPARATOR

Deep brain stimulation

Intervention Type DEVICE

Bilateral DBS

Intra-thecal Baclofen infusion therapy

Intra-thecal infusion pump

Group Type ACTIVE_COMPARATOR

Intra-thecal baclofen infusion

Intervention Type DEVICE

Intra-thecal Baclofen infusion

Interventions

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Brain Lesioning

Stereotactic radiofrequency lesioning of the pallidum or thalamus

Intervention Type PROCEDURE

Combined anterior and posterior lumbosacral rhizotomy

Combined anterior and posterior lumbosacral rhizotomy

Intervention Type PROCEDURE

Deep brain stimulation

Bilateral DBS

Intervention Type DEVICE

Intra-thecal baclofen infusion

Intra-thecal Baclofen infusion

Intervention Type DEVICE

Other Intervention Names

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DBS ITB

Eligibility Criteria

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Inclusion Criteria

* secondary dystonia of previous etiologies

Exclusion Criteria

* patients who are not candidate for anaesthesia
Minimum Eligible Age

3 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ain Shams University

OTHER

Sponsor Role lead

Responsible Party

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Mohamed Nada

Fellow

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Walid A Abdel Ghany, MD

Role: STUDY_DIRECTOR

Associate professor

Other Identifiers

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4996

Identifier Type: -

Identifier Source: org_study_id