Neuroprosthetic Device for Improving Issues Caused by Diabetic Neuropathy With Specifically Designed Neural Stimulation

NCT ID: NCT06471517

Last Updated: 2024-06-24

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

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-13

Study Completion Date

2025-07-31

Brief Summary

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Neuropathy refers to a condition that results from damage to the peripheral nerves.The most common cause of it is diabetes mellitus, metabolic disorder that affects more than 422 million individuals worldwide, putting a huge strain on the healthcare system and up to 50% of these individuals will develop neuropathy. Peripheral neuropathy is characterized by sensory nerve abnormalities such as an impaired sense of touch. Sensory loss in feet can lead to functional deficits during gait, low balance, and increased risk of falls and is considered the strongest risk factor for diabetic foot ulceration. Moreover, these patients usually also suffer from neuropathic pain, which is believed to be associated with aberrant sensory input.

With this in mind, the study aims to understand the effects of restoring sensation lost to neuropathy using transcutaneous electrical stimulation. Additionally, the investigators aim to understand if electrical stimulation of the damaged nerves can reduce health consequences such as chronic pain.

To achieve this, the investigators have developed a wearable sensory restoration system that can restore lost sensation with non-invasive, precisely controlled electrical stimulation through electrodes integrated into the sock garment. A system is composed of a system controller that communicates via Bluetooth with force-sensitive insoles placed in the shoes and neurostimulators directly connected to electrode array socks. Based on the insole recordings the stimulation parameters are defined in real-time, making it a closed-loop system for restoring somatotopic sensory feedback.

Detailed Description

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Conditions

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Neuropathy;Peripheral Neuropathy, Diabetic Neuropathy, Painful

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Somatosensory feedback

Somatotopic sensory feedback elicited by transcutaneous electrical stimulation (TENS) will be provided to the patients using electrodes integrated into the garment sock. The closed loop system provides stimulation parameter change based on the data recorded with sensorized insoles.

Group Type EXPERIMENTAL

Somatosensory feedback

Intervention Type DEVICE

Performing different mobility tasks in 10 separate sessions while the device is providing or not somatotopic sensations through non-invasive electrical stimulation. Benefits connected to the stimulation of sensory nerves will be assessed.

Interventions

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Somatosensory feedback

Performing different mobility tasks in 10 separate sessions while the device is providing or not somatotopic sensations through non-invasive electrical stimulation. Benefits connected to the stimulation of sensory nerves will be assessed.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Diagnosed polyneuropathy
* Ability to stand and walk unassisted.
* Sensory loss in the feet

Exclusion Criteria

* Open ulcers on the feet
* Pregnancy
* History of or current psychological diseases that include schizophrenia and major depression
* Hypersensitivity to electrical stimulation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Clinical Centre of Serbia

OTHER

Sponsor Role collaborator

University of Belgrade

OTHER

Sponsor Role collaborator

ETH Zurich

OTHER

Sponsor Role collaborator

Institute Mihajlo Pupin

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stanisa Raspopovic, PhD

Role: PRINCIPAL_INVESTIGATOR

Institute Mihajlo Pupin

Locations

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Clinics for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia

Belgrade, , Serbia

Site Status RECRUITING

Countries

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Serbia

Central Contacts

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Natalija Secerovic, PhD

Role: CONTACT

+381631268862

Facility Contacts

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Vesna Dimitrijevic Sreckovic, PhD

Role: primary

+381638765330

References

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Sloan G, Selvarajah D, Tesfaye S. Pathogenesis, diagnosis and clinical management of diabetic sensorimotor peripheral neuropathy. Nat Rev Endocrinol. 2021 Jul;17(7):400-420. doi: 10.1038/s41574-021-00496-z. Epub 2021 May 28.

Reference Type BACKGROUND
PMID: 34050323 (View on PubMed)

Dailey DL, Rakel BA, Vance CGT, Liebano RE, Amrit AS, Bush HM, Lee KS, Lee JE, Sluka KA. Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia. Pain. 2013 Nov;154(11):2554-2562. doi: 10.1016/j.pain.2013.07.043. Epub 2013 Jul 27.

Reference Type BACKGROUND
PMID: 23900134 (View on PubMed)

Koke AJ, Schouten JS, Lamerichs-Geelen MJ, Lipsch JS, Waltje EM, van Kleef M, Patijn J. Pain reducing effect of three types of transcutaneous electrical nerve stimulation in patients with chronic pain: a randomized crossover trial. Pain. 2004 Mar;108(1-2):36-42. doi: 10.1016/j.pain.2003.11.013.

Reference Type BACKGROUND
PMID: 15109505 (View on PubMed)

Chee L, Valle G, Marazzi M, Preatoni G, Haufe FL, Xiloyannis M, Riener R, Raspopovic S. Optimally-calibrated non-invasive feedback improves amputees' metabolic consumption, balance and walking confidence. J Neural Eng. 2022 Aug 25;19(4). doi: 10.1088/1741-2552/ac883b.

Reference Type BACKGROUND
PMID: 35944515 (View on PubMed)

Oddsson LIE, Bisson T, Cohen HS, Iloputaife I, Jacobs L, Kung D, Lipsitz LA, Manor B, McCracken P, Rumsey Y, Wrisley DM, Koehler-McNicholas SR. Extended effects of a wearable sensory prosthesis on gait, balance function and falls after 26 weeks of use in persons with peripheral neuropathy and high fall risk-The walk2Wellness trial. Front Aging Neurosci. 2022 Sep 20;14:931048. doi: 10.3389/fnagi.2022.931048. eCollection 2022.

Reference Type BACKGROUND
PMID: 36204554 (View on PubMed)

Petrini FM, Bumbasirevic M, Valle G, Ilic V, Mijovic P, Cvancara P, Barberi F, Katic N, Bortolotti D, Andreu D, Lechler K, Lesic A, Mazic S, Mijovic B, Guiraud D, Stieglitz T, Alexandersson A, Micera S, Raspopovic S. Sensory feedback restoration in leg amputees improves walking speed, metabolic cost and phantom pain. Nat Med. 2019 Sep;25(9):1356-1363. doi: 10.1038/s41591-019-0567-3. Epub 2019 Sep 9.

Reference Type BACKGROUND
PMID: 31501600 (View on PubMed)

Petrini FM, Valle G, Bumbasirevic M, Barberi F, Bortolotti D, Cvancara P, Hiairrassary A, Mijovic P, Sverrisson AO, Pedrocchi A, Divoux JL, Popovic I, Lechler K, Mijovic B, Guiraud D, Stieglitz T, Alexandersson A, Micera S, Lesic A, Raspopovic S. Enhancing functional abilities and cognitive integration of the lower limb prosthesis. Sci Transl Med. 2019 Oct 2;11(512):eaav8939. doi: 10.1126/scitranslmed.aav8939.

Reference Type BACKGROUND
PMID: 31578244 (View on PubMed)

Basla C, Chee L, Valle G, Raspopovic S. A non-invasive wearable sensory leg neuroprosthesis: mechanical, electrical and functional validation. J Neural Eng. 2022 Jan 24;19(1). doi: 10.1088/1741-2552/ac43f8.

Reference Type BACKGROUND
PMID: 34915454 (View on PubMed)

Najafi B, Talal TK, Grewal GS, Menzies R, Armstrong DG, Lavery LA. Using Plantar Electrical Stimulation to Improve Postural Balance and Plantar Sensation Among Patients With Diabetic Peripheral Neuropathy: A Randomized Double Blinded Study. J Diabetes Sci Technol. 2017 Jul;11(4):693-701. doi: 10.1177/1932296817695338. Epub 2017 Feb 1.

Reference Type BACKGROUND
PMID: 28627217 (View on PubMed)

Zeb A, Arsh A, Bahadur S, Ilyas SM. Effectiveness of transcutaneous electrical nerve stimulation in management of neuropathic pain in patients with post traumatic incomplete spinal cord injuries. Pak J Med Sci. 2018 Sep-Oct;34(5):1177-1180. doi: 10.12669/pjms.345.15659.

Reference Type BACKGROUND
PMID: 30344571 (View on PubMed)

Celik EC, Erhan B, Gunduz B, Lakse E. The effect of low-frequency TENS in the treatment of neuropathic pain in patients with spinal cord injury. Spinal Cord. 2013 Apr;51(4):334-7. doi: 10.1038/sc.2012.159. Epub 2013 Jan 8.

Reference Type BACKGROUND
PMID: 23295472 (View on PubMed)

Reeves ND, Orlando G, Brown SJ. Sensory-Motor Mechanisms Increasing Falls Risk in Diabetic Peripheral Neuropathy. Medicina (Kaunas). 2021 May 8;57(5):457. doi: 10.3390/medicina57050457.

Reference Type BACKGROUND
PMID: 34066681 (View on PubMed)

Raspovic A. Gait characteristics of people with diabetes-related peripheral neuropathy, with and without a history of ulceration. Gait Posture. 2013 Sep;38(4):723-8. doi: 10.1016/j.gaitpost.2013.03.009. Epub 2013 Apr 11.

Reference Type BACKGROUND
PMID: 23583607 (View on PubMed)

Pfau DB, Geber C, Birklein F, Treede RD. Quantitative sensory testing of neuropathic pain patients: potential mechanistic and therapeutic implications. Curr Pain Headache Rep. 2012 Jun;16(3):199-206. doi: 10.1007/s11916-012-0261-3.

Reference Type BACKGROUND
PMID: 22535540 (View on PubMed)

Perkins BA, Olaleye D, Zinman B, Bril V. Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes Care. 2001 Feb;24(2):250-6. doi: 10.2337/diacare.24.2.250.

Reference Type BACKGROUND
PMID: 11213874 (View on PubMed)

Bridenbaugh SA, Kressig RW. Laboratory review: the role of gait analysis in seniors' mobility and fall prevention. Gerontology. 2011;57(3):256-64. doi: 10.1159/000322194. Epub 2010 Oct 27.

Reference Type BACKGROUND
PMID: 20980732 (View on PubMed)

Other Identifiers

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DiabeticStim

Identifier Type: -

Identifier Source: org_study_id

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