Efficacy and Safety of Spinal Cord Stimulation in Patients With Spinal Cord Stimulation

NCT ID: NCT06515132

Last Updated: 2025-01-07

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-10

Study Completion Date

2026-05-30

Brief Summary

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Investigating the efficacy and safety of spinal cord stimulation for patients with disorders of consciousness.

Detailed Description

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Disorder of Consciousness (DOC) is a highly significant and concerning consequence that frequently ensues various acute brain injuries. The DOC encompasses coma, unresponsive wakefulness syndrome (UWS), also known as persistent vegetative state (PVS), and minimally conscious state (MCS). Currently, the available treatments for arousing patients with DOC are relatively limited, encompassing pharmacotherapy, hyperbaric oxygen therapy, neuromodulation, physical rehabilitation exercises, and traditional Chinese acupuncture. Among these approaches, only amantadine and transcranial direct current stimulation have demonstrated efficacy in DOC patients; however, further extensive validation is still warranted.

In recent years, spinal cord stimulation (SCS) has emerged as a cutting-edge and extensively researched modality for arousal therapy. SCS is a form of neuromodulation therapy primarily utilized for intractable pain, diabetic neuropathy, and muscle spasticity, the therapeutic efficacy of the SCS is both significant and safe. Although preliminary studies have demonstrated the potential of SCS in promoting arousal in patients with DOC, these findings are currently limited to small sample reports. Therefore, this multicenter randomized controlled trial aims to provide robust evidence on the effectiveness of SCS in promoting arousal among patients with DOC, thereby standardizing its clinical application and offering advanced evidence-based medicine for DOC management.

Conditions

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Disorder of Consciousness Spinal Cord Stimulation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
This study is being conducted as a double-blind trial, wherein the surgeons, assessors and participants' family members are kept unaware of the assigned research groups. However, it is necessary to inform the physicians responsible for adjustment of stimulation parameters about the allocation of participants. Follow-up assessments of participants after stimulation will be conducted by an independent assessor using standardized evaluation criteria.

Study Groups

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SCS group

SCS stimulation therapy is initiated 1 week post-surgery, which is administered continuously for a duration of 6 months.

Group Type EXPERIMENTAL

SCS Stimulation

Intervention Type PROCEDURE

Participants will accept the SCS stimulus for six months

Sham group

Sham stimulation therapy is initiated 1 week post-surgery, and SCS stimulation therapy is initiated 3 months post-surgery, which is stimulated continuously for a duration of 3 months.

Group Type SHAM_COMPARATOR

Sham Stimulation

Intervention Type PROCEDURE

Sham stimulation will be performed in the first three months after surgery, and SCS stimulation will be started in the fourth month after surgery

Interventions

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SCS Stimulation

Participants will accept the SCS stimulus for six months

Intervention Type PROCEDURE

Sham Stimulation

Sham stimulation will be performed in the first three months after surgery, and SCS stimulation will be started in the fourth month after surgery

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Male and female patients between the ages of 18 and 65, experiencing DOC for a duration ranging from 3 months to 1 year following brain disease.
* Patients diagnosed with DOC as a consequence of traumatic brain injury, hypertensive intracerebral hemorrhage, or severe cerebral infarction.
* Patients exhibiting stable cerebral anatomy and no need for further cranioplasty or hydrocephalus shunt.
* Patients in MCS, who fulfill at least one of the following criteria: ① Demonstrating an oriented response to noxious stimuli; ② Exhibiting sustained eye tracking behavior; ③ Displaying purposeful movements; ④ Manifesting comprehension of language or emotions and actions (often observed in specific environments such as when hearing family members crying).
* The vital signs and state of consciousness are stable: normal body temperature, the spontaneous breathing is stable (minimal sputum production and respiratory stability without oxygen supplementation for at least 2 hours); there is no significant change in the level of consciousness for at least 1 month and more.
* Presence of short-latency responses (N20/P25) on somatosensory evoked potentials (SEP) recorded from the median nerve in the upper limbs.
* Written informed consent obtained from legal guardians or representatives.

Exclusion Criteria

* Patients with a history of severe neurological or psychiatric disorders, or other significant diseases impacting prognosis prior to the onset of DOC;
* Patients with contraindications for surgery, such as acute infections or coagulation disorders;
* Patients who require short-wave diathermy treatment and are unable to undergo neurostimulation;
* Patients with hypoxic brain injury due to suffocation, cardiac arrest, or respiratory arrest;
* Patients with brainstem hemorrhage;
* Pregnant women;
* Patients who voluntarily request SCS implantation but are unwilling to cooperate with the research protocol;
* Participants in other clinical trials.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Xiangya Hospital of Central South University

OTHER

Sponsor Role collaborator

First Affiliated Hospital of Fujian Medical University

OTHER

Sponsor Role collaborator

Huashan Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xuehai Wu

Deputy Director of Shanghai Neurosurgical Emergency Center

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xuehai Wu, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Department of Neurosurgery, Huashan Hospital, Fudan University

Locations

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The First Affiliated Hospital of Fujian Medical University

Fuzhou, Fujian, China

Site Status RECRUITING

Xiangya Hospital,Central South University

Changsha, Hunan, China

Site Status RECRUITING

Department of Neurosurgery, Huashan Hospital, Fudan University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xuehai Wu, Ph.D.

Role: CONTACT

+8613764880571

Lijian Lang, M.M.

Role: CONTACT

+8613896851367

Facility Contacts

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Peisen Yao, Ph.D.

Role: primary

18650084102

Zhongyi Sun, Ph.D.

Role: primary

18163618671

Xuehai Wu, Ph.D.

Role: primary

+8613764880571

References

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Other Identifiers

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KY2024-752

Identifier Type: -

Identifier Source: org_study_id

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