Spinal Cord Stimulation for Gait Dysfunction in Parkinson's Disease

NCT ID: NCT06005584

Last Updated: 2023-08-22

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

8 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-01

Study Completion Date

2026-02-28

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Parkinson's disease (PD) is the second commonest neurodegenerative disorder, affecting over 145,000 people in the UK. Initially, PD patients experience slowness of movements, limb stiffness, and tremor.

With progressive loss of neurons over time, many patients start to experience balance and walking problems, and falls, which are resistant to currently available treatments. Falls can lead to fractures and nursing home admission, and can significantly shorten patients' life expectancy.

In this pilot study, the investigators will investigate the effects of spinal cord stimulation (SCS) on gait and balance in PD. Some open-labelled studies have shown possible beneficial effects of SCS in PD, although it is uncertain which type of PD patients will benefit most and which stimulation parameters work best. The investigators will assess the effects of SCS on posture and gait using a series of clinical, laboratory, imaging, and wearable measurements.

The participants will receive a percutaneous implantation of a spinal cord stimulator to minimise the possible adverse effects related to the surgery.

The SCS will start one month after surgery. The investigators will use a double-blind cross-over design. The participants will receive three different stimulation parameters, including sham stimulation, in a randomised order. The participants and the assessors will be blinded to the stimulation parameters.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The investigators aim to recruit up to 8 people with Parkinson's with significant gait dysfunction which is resistant to medical therapy to this study. All participants will receive implantation of a spinal cord stimulator at T8-10 levels. The procedure will be done percutaneously. The spinal cord stimulation will be commenced 2-4 weeks after surgery to allow time for recovery.

Participants will receive 3 different stimulation parameters in randomised order as outlined below:

1. Burst stimulation
2. High frequency stimulation
3. Sham stimulation Each parameter will last for up to 6 weeks. Both the patients and the researchers assessing the patients will be blinded to the settings parameters. At baseline and at the end of each stimulation settings, the participants will undergo a series of assessments (see secondary outcomes). At the end of the cross-over blinded period, the participants will be unblinded and offered to continue with the parameter that offered most symptomatic relief. The participants will then continue in this setting in an open label phase for another 10 weeks before their final assessment at 7 months.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Parkinson Disease Freezing of Gait

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

High Frequency SCS

Participants will be randomly assigned to this arm for up to 6 weeks

Group Type ACTIVE_COMPARATOR

Spinal Cord Stimulation - High Frequency SCS

Intervention Type DEVICE

High Frequency-SCS consists of delivering electrical stimulation at frequencies equal to or greater than 1kHz.

This intervention will last up to 6 weeks.

Burst SCS

Participants will be randomly assigned to this arm for up to 6 weeks

Group Type ACTIVE_COMPARATOR

Spinal Cord Stimulation - Burst SCS

Intervention Type DEVICE

Burst SCS consists of closely spaced, high frequency stimuli delivered to the spinal cord.

This intervention will last up to 6 weeks.

Sham SCS

Participants will be randomly assigned to this arm for up to 6 weeks

Group Type SHAM_COMPARATOR

Spinal Cord Stimulation - Sham SCS

Intervention Type DEVICE

This intervention will last up to 6 weeks.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Spinal Cord Stimulation - High Frequency SCS

High Frequency-SCS consists of delivering electrical stimulation at frequencies equal to or greater than 1kHz.

This intervention will last up to 6 weeks.

Intervention Type DEVICE

Spinal Cord Stimulation - Burst SCS

Burst SCS consists of closely spaced, high frequency stimuli delivered to the spinal cord.

This intervention will last up to 6 weeks.

Intervention Type DEVICE

Spinal Cord Stimulation - Sham SCS

This intervention will last up to 6 weeks.

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Age: 45 ≤ X ≤ 85
* PD diagnosis based on UK Parkinson's disease society brain bank criteria
* Significant gait dysfunction, particularly freezing of gait, which is resistant to optimal medical therapy
* Hoen and Yahr stage: 2-4 (in ON state)
* Stable dopaminergic treatment for at least two weeks before enrolment.
* Can provide informed consent

Exclusion Criteria

* Atypical or secondary parkinsonism e.g. vascular, drug-induced
* Major focal brain disorders (including malignancy or stroke)
* Recent (within 3 months)/current use of acetylcholinesterase inhibitors or antidopaminergic drugs
* Concomitant treatment with deep brain stimulation
* Neurological, vestibular, visual or orthopaedic diagnosis significantly interfering with gait
* Pregnant women or planning to become pregnant
* Significant chronic back pain
* Spinal anatomical abnormalities precluding SCS surgery
* Major cognitive or psychiatric illness
* Concomitant or recent (less than 4 months) enrolment in an interventional research trial.
Minimum Eligible Age

45 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Imperial College London

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Yen Tai

Role: PRINCIPAL_INVESTIGATOR

Imperial College London

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Imperial College London

London, , United Kingdom

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United Kingdom

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Yen Tai

Role: CONTACT

+442033111182

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Matteo Ciocca

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

22CX7894

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Gait Disorders in Parkinson's Disease
NCT03416452 WITHDRAWN EARLY_PHASE1