Central Programming in Patients With a Bionic Hand After Traumatic Brachial Plexus Injury

NCT ID: NCT04649749

Last Updated: 2023-09-28

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

COMPLETED

Total Enrollment

11 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-10-01

Study Completion Date

2022-09-01

Brief Summary

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Traumatic brachial plexus lesions may lead to permanent impairment of hand function despite brachial plexus surgery. In selected cases the affected forearm can be amputated and replaced by a bionic hand. It is unclear how cortical activation patterns change after the injury and after acquisition of the hand prosthesis considering the complex changes in sensory and motor feedback. The aim of the study is to measure cortical activity with fMRI during actual and imagery movements with the affected and healthy arm in a group of patients after traumatic brachial plexus injury and a group in whom this was followed by replacement with a bionic hand. In this prospective study three groups of patients will participate: 1) 3 adult patients with a traumatic brachial plexus lesion eligible for a bionic arm but prior to its acquisition, 2) 3 patients with a traumatic brachial plexus lesion who have acquired the bionic arm already, and 3) 10 healthy subjects. The investigators will measure cortical activity using fMRI BOLD tasks of closing the hand and motor imagery of this movement. Cortical activity will be compared between the three groups. Additionally, regional gray matter volume, resting-state, and DTI networks will be studied. Written informed consent will be provided prior to the investigation. The complete examination has a duration of approximately 45 minutes.

Detailed Description

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Conditions

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Brachial Plexus Neuropathies Traumatic Brachial Plexus Lesion Bionic Hand Reconstruction

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Patients - bionic hand acquired

3 adult patients who acquired a bionic hand at the Medical University of Vienna after a traumatic brachial plexus lesion.

MRI

Intervention Type DIAGNOSTIC_TEST

MRI scan

Patients - bionic hand not yet acquired

3 patients eligible for the bionic hand prior to a possible amputation.

MRI

Intervention Type DIAGNOSTIC_TEST

MRI scan

Control subjects

Ten control subjects will be included for comparison.

MRI

Intervention Type DIAGNOSTIC_TEST

MRI scan

Interventions

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MRI

MRI scan

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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functional MRI fMRI

Eligibility Criteria

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Inclusion Criteria

* age above 18 years
* participants should understand German or English
* patients with a bionic hand are selected who are able to open and close the hand prosthesis.

Exclusion Criteria

* the standard contraindications for MRI will be checked for according to hospital protocol (ferromagnetic devices such as clips, claustrophobia, etc.) and, if necessary, patients will be excluded from participation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Medical University of Vienna

OTHER

Sponsor Role lead

Responsible Party

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Galia Valentinova Anguelova

Visiting Researcher at Medical University of Vienna, Austria

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Oskar Aszmann, prof. dr.

Role: PRINCIPAL_INVESTIGATOR

Medical University of Vienna

Locations

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Medical University of Vienna

Vienna, , Austria

Site Status

Countries

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Austria

References

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Aszmann OC, Roche AD, Salminger S, Paternostro-Sluga T, Herceg M, Sturma A, Hofer C, Farina D. Bionic reconstruction to restore hand function after brachial plexus injury: a case series of three patients. Lancet. 2015 May 30;385(9983):2183-9. doi: 10.1016/S0140-6736(14)61776-1. Epub 2015 Feb 25.

Reference Type BACKGROUND
PMID: 25724529 (View on PubMed)

Sturma A, Hruby LA, Prahm C, Mayer JA, Aszmann OC. Rehabilitation of Upper Extremity Nerve Injuries Using Surface EMG Biofeedback: Protocols for Clinical Application. Front Neurosci. 2018 Dec 4;12:906. doi: 10.3389/fnins.2018.00906. eCollection 2018.

Reference Type BACKGROUND
PMID: 30564090 (View on PubMed)

Decety J, Grezes J. Neural mechanisms subserving the perception of human actions. Trends Cogn Sci. 1999 May;3(5):172-178. doi: 10.1016/s1364-6613(99)01312-1.

Reference Type BACKGROUND
PMID: 10322473 (View on PubMed)

Lotze M, Flor H, Grodd W, Larbig W, Birbaumer N. Phantom movements and pain. An fMRI study in upper limb amputees. Brain. 2001 Nov;124(Pt 11):2268-77. doi: 10.1093/brain/124.11.2268.

Reference Type BACKGROUND
PMID: 11673327 (View on PubMed)

Hotz-Boendermaker S, Funk M, Summers P, Brugger P, Hepp-Reymond MC, Curt A, Kollias SS. Preservation of motor programs in paraplegics as demonstrated by attempted and imagined foot movements. Neuroimage. 2008 Jan 1;39(1):383-94. doi: 10.1016/j.neuroimage.2007.07.065. Epub 2007 Aug 23.

Reference Type BACKGROUND
PMID: 17919932 (View on PubMed)

Date S, Kurumadani H, Yoshimura M, Fukae A, Onishi K, Hayashi J, Shinomiya R, Sunagawa T. Long-term disuse of the hand affects motor imagery ability in patients with complete brachial plexus palsy. Neuroreport. 2019 Apr 10;30(6):452-456. doi: 10.1097/WNR.0000000000001229.

Reference Type BACKGROUND
PMID: 30855560 (View on PubMed)

Anguelova GV, Rombouts SARB, van Dijk JG, Buur PF, Malessy MJA. Increased brain activation during motor imagery suggests central abnormality in Neonatal Brachial Plexus Palsy. Neurosci Res. 2017 Oct;123:19-26. doi: 10.1016/j.neures.2017.05.001. Epub 2017 May 4.

Reference Type BACKGROUND
PMID: 28479130 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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1955/2020

Identifier Type: -

Identifier Source: org_study_id

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