Cerebellar iTBS in Patients With Disorders of Consciousness

NCT ID: NCT05558930

Last Updated: 2022-09-28

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-29

Study Completion Date

2023-10-31

Brief Summary

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Previous studies showed the excitatory effect of cerebellar transcranial magnetic stimulation(TMS) on motor cortex.Investigator evaluate the effects of bilateral cerebellar TMS on Coma Recovery Scale-Revised (CRS-R) scores in patients with disorders of consciousness(DOC) in a randomized, double-blinded, sham-controlled, crossover experimental design.

Detailed Description

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Patients with disorders of consciousness(DOC) resulting from severe brain injury greatly burden caregivers, health care facilities, and society. However, there is no definitively effective treatment for patients with DOC.

Previous studies showed the excitatory effect of cerebellar transcranial magnetic stimulation(TMS) on motor cortex through the dentato-rubro-thalamic tract. Investigators aim to validate the effect of 5 consecutive sessions of intermittent theta-burst stimulation(iTBS) of bilateral cerebellar on level of consciousness of patients in vegetative state(VS)/unresponsive awakening state(UWS)or minimally conscious (MCS) state in a randomized, double-blinded, sham-controlled, crossover study.

TMS is a non-invasive and safe neural regulatory approach that is widely used in depression, schizophrenia, stroke, and Parkinson's disease.

Conditions

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Disorder of Consciousness Vegetative State Minimally Conscious State

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

A randomized double-blinded, sham-controlled, crossover study design is used to investigate the effects of bilateral cerebellar iTBS on patients with prolonged DOC in a VS/UWS or in a MCS state. We prospectively recruit 44 patients in VS/UWS or MCS state. Each patient will receive bilateral cerebellar iTBS and sham stimulation in random order, one session per day for 5 consecutive days, separated by a 5-day washout. TMS is performed by personalized neuro-navigation to target the cerebellar dentate nucleus. The primary research outcome is whether bilateral cerebellar iTBS, as compared to sham stimulation, will improve consciousness (as measured by changes in CRS-R total scores) in VS/UWS and MCS patients. Secondary research outcome is evaluated by Electroencephalogram(EEG), CRS-R subscore, and Glasgow Outcome Scale-Extended(GOSE) score at 3 and 6 months of enrollment.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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iTBS stimulation

Participants receive iTBS stimulation of bilateral cerebellar one session per day for 5 consecutive days.

Group Type EXPERIMENTAL

iTBS stimulation

Intervention Type DEVICE

standard iTBS burst pattern:3 pulses at 50-Hz repeated at a rate of 5-Hz; 20 trains of 10 bursts given with 8-s intervals. 600 pulses on both side of cerebellar with an interval of 5 minutes.

sham stimulation

Participants receive sham stimulation of bilateral cerebellar one session per day for 5 consecutive days.

Group Type SHAM_COMPARATOR

sham stimulation

Intervention Type DEVICE

Participants receive a sound stimulation with the same pattern with iTBS stimulation,but without magnetic field

Interventions

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iTBS stimulation

standard iTBS burst pattern:3 pulses at 50-Hz repeated at a rate of 5-Hz; 20 trains of 10 bursts given with 8-s intervals. 600 pulses on both side of cerebellar with an interval of 5 minutes.

Intervention Type DEVICE

sham stimulation

Participants receive a sound stimulation with the same pattern with iTBS stimulation,but without magnetic field

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. VS/UWS or MCS according to diagnostic criteria
2. Age ≥18 years
3. Written informed consent obtained

Exclusion Criteria

1. Patients in coma
2. Brain injury \<1week
3. Presence of metallic hardware in close contact to the discharging coil(such as cochlear implants, or an Internal Pulse Generator or medication pumps)
4. Patients with high risks according to standard questionnaire to screen transcranial magnetic stimulation(TMS) candidates
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Xijing Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Xijing hospital, Air Force Military Medical University

Xi'an, Shaanxi, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Rong Chen

Role: CONTACT

18292575563

Wen Jiang

Role: CONTACT

Facility Contacts

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Rong Chen

Role: primary

18292575563

Other Identifiers

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20222028

Identifier Type: -

Identifier Source: org_study_id

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