Spinal Cord Stimulation and Training

NCT ID: NCT05472584

Last Updated: 2025-03-28

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

RECRUITING

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-21

Study Completion Date

2027-08-31

Brief Summary

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This study will help the investigators better understand the changes in short-term excitability and long-term plasticity of corticospinal, reticulospinal and spinal neural circuits and how the changes impact the improvements of spinal cord stimulation (SCS) mediated motor function.

Detailed Description

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The goal of this project is to determine the changes in short-term excitability and long-term plasticity of corticospinal, reticulospinal, and spinal neural circuits that are involved in SCS-mediated motor function improvements in individuals with spinal cord injury (SCI). The study will: (1) Determine the short-term effects in neural excitability induced by SCS and activity-based training. (2) Determine the effect of motor training on short-term changes in neural excitability enabled by SCS. (3) Determine the long-term changes in motor control and neural plasticity induced by combined SCS and activity-based training in individuals with chronic SCI. Having a better understanding of the neural mechanisms that are enhanced by SCS can allow the development of therapies that directly target the excitability and plasticity states of these structures towards improved and accelerated recovery.

Conditions

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Spinal Cord Injuries

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Experimental: Non-invasive spinal cord stimulation

This arm will receive 30 minutes of transcutaneous spinal cord stimulation as participants rest.

Group Type EXPERIMENTAL

Electrophysiology assessment - corticospinal tract

Intervention Type OTHER

Kinematics and cortical spinal motor excitability

Electrophysiology assessment - reticulospinal tract

Intervention Type OTHER

Kinematics and reticular spinal motor excitability

Electrophysiology assessment - spinal motoneuron

Intervention Type OTHER

Kinematics and spinal motoneuron excitability

Transcutaneous spinal cord stimulation

Intervention Type OTHER

Non-invasive spinal cord stimulation

Experimental: Activity-based training

This arm will perform 30 minutes of activity-based training using leg movements.

Group Type EXPERIMENTAL

Electrophysiology assessment - corticospinal tract

Intervention Type OTHER

Kinematics and cortical spinal motor excitability

Electrophysiology assessment - reticulospinal tract

Intervention Type OTHER

Kinematics and reticular spinal motor excitability

Electrophysiology assessment - spinal motoneuron

Intervention Type OTHER

Kinematics and spinal motoneuron excitability

Activity-based training

Intervention Type OTHER

Motor task

Experimental: Activity-based training wtih non-invasive spinal cord stimulation

This arm will receive transcutaneous spinal cord stimulation as participants perform 30 minutes of activity-based training using leg movements.

Group Type EXPERIMENTAL

Electrophysiology assessment - corticospinal tract

Intervention Type OTHER

Kinematics and cortical spinal motor excitability

Electrophysiology assessment - reticulospinal tract

Intervention Type OTHER

Kinematics and reticular spinal motor excitability

Electrophysiology assessment - spinal motoneuron

Intervention Type OTHER

Kinematics and spinal motoneuron excitability

Activity-based training

Intervention Type OTHER

Motor task

Transcutaneous spinal cord stimulation

Intervention Type OTHER

Non-invasive spinal cord stimulation

Experimental: Non-invasive spinal cord stimulation and strength training

This arm will receive transcutaneous spinal cord stimulation as participants perform strengthening exercises.

Group Type EXPERIMENTAL

Electrophysiology assessment - corticospinal tract

Intervention Type OTHER

Kinematics and cortical spinal motor excitability

Electrophysiology assessment - reticulospinal tract

Intervention Type OTHER

Kinematics and reticular spinal motor excitability

Electrophysiology assessment - spinal motoneuron

Intervention Type OTHER

Kinematics and spinal motoneuron excitability

Activity-based training

Intervention Type OTHER

Motor task

Transcutaneous spinal cord stimulation

Intervention Type OTHER

Non-invasive spinal cord stimulation

Experimental: Non-invasive spinal cord stimulation and precision training

This arm will receive transcutaneous spinal cord stimulation as participants perform precision-control and dexterity exercises.

Group Type EXPERIMENTAL

Electrophysiology assessment - corticospinal tract

Intervention Type OTHER

Kinematics and cortical spinal motor excitability

Electrophysiology assessment - reticulospinal tract

Intervention Type OTHER

Kinematics and reticular spinal motor excitability

Electrophysiology assessment - spinal motoneuron

Intervention Type OTHER

Kinematics and spinal motoneuron excitability

Activity-based training

Intervention Type OTHER

Motor task

Transcutaneous spinal cord stimulation

Intervention Type OTHER

Non-invasive spinal cord stimulation

Experimental: Long-term activity-based training with non-invasive spinal cord stimulation

This arm will receive 4 weeks of activity-based training with transcutaneous spinal cord stimulation

Group Type EXPERIMENTAL

Electrophysiology assessment - corticospinal tract

Intervention Type OTHER

Kinematics and cortical spinal motor excitability

Electrophysiology assessment - reticulospinal tract

Intervention Type OTHER

Kinematics and reticular spinal motor excitability

Electrophysiology assessment - spinal motoneuron

Intervention Type OTHER

Kinematics and spinal motoneuron excitability

Activity-based training

Intervention Type OTHER

Motor task

Transcutaneous spinal cord stimulation

Intervention Type OTHER

Non-invasive spinal cord stimulation

Interventions

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Electrophysiology assessment - corticospinal tract

Kinematics and cortical spinal motor excitability

Intervention Type OTHER

Electrophysiology assessment - reticulospinal tract

Kinematics and reticular spinal motor excitability

Intervention Type OTHER

Electrophysiology assessment - spinal motoneuron

Kinematics and spinal motoneuron excitability

Intervention Type OTHER

Activity-based training

Motor task

Intervention Type OTHER

Transcutaneous spinal cord stimulation

Non-invasive spinal cord stimulation

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Healthy Volunteers

* Age between 16 and 65 years old
* Healthy people with no major comorbidities of any organ system


Participants with spinal cord injury (SCI)

* Age between 16-65 years old
* Traumatic SCI C4-T9 level, incomplete (ASIA C or D)
* at least 1 year post injury
* Stable medical condition
* difficulty independently performing leg movements in routine activities
* able to follow simple commands
* able to speak and respond to questions

Exclusion Criteria

Healthy Volunteers

* Subjects younger than 16 or older than 65 years old
* Subjects not providing consent or not able to consent
* Subjects with any acute or chronic pain condition
* Subjects with any acute or chronic disease of a major organ system
* Use of analgesics within 24 hours prior to study period
* Use of caffeine with 3 hours of study appointment


Participants with spinal cord injury (SCI)

* Subjects younger than 16 or older than 65 years old
* Not willing or able to provide consent
* Any acute or chronic pain condition
* Any acute or chronic disease of a major organ system
* Use of analgesics within 24 hours prior to study appointment
* Use of caffeine with 3 hours of study appointment
* Presence of tremors, spasms and other significant involuntary movements
* Etiology of SCI other than trauma
* Concomitant neurologic disease traumatic brain injury (TBI) that will significantly impact the ability to follow through on study directions, multiple sclerosis (MS), stroke or peripheral neuropathy)
* History of significant medical illness (cardiovascular disease, uncontrolled diabetes, uncontrolled hypertension, osteoporosis, cancer, chronic obstructive pulmonary disease, severe asthma requiring hospitalization for treatment, renal insufficiency requiring dialysis, autonomic dysreflexia, etc).
* Severe joint contractures disabling or restricting lower limb movements.
* Unhealed fracture, contracture, pressure sore, urinary tract infection or other uncontrolled infections, other illnesses that might interfere with lower extremity exercises or testing activities
* Depression, anxiety, or cognitive impairment
* Deficit of visuospatial orientation
* Sitting tolerance less than 1 hour
* Severe hearing or visual deficiency
* Miss more than 3 appointments without notification
* Unable to comply with any of the procedures in the protocol
* Botulinum toxin injection in lower extremity muscles in the prior six months
* Any passive implants (osteosynthesis material, metallic plates or screws) below T9.
* Any implanted stimulator in the body (pacemaker, vagus nerve stimulator, etc.)
* History of alcoholism or another drug abuse
* Pregnancy (or possible pregnancy)
* Having an Intrathecal Baclofen Therapy Pump (ITB pump)
* History of epilepsy
Minimum Eligible Age

16 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Ismael Seáñez

Assistant Professor of Biomedical Engineering and Neurosurgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ismael Seanez, PhD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

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Washington University

St Louis, Missouri, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ismael Seanez, PHD

Role: CONTACT

314-935-7665

Facility Contacts

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Ismael Seanez, PHD

Role: primary

314-935-7665

Other Identifiers

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202206159

Identifier Type: -

Identifier Source: org_study_id

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