Guttmann NeuroRecovery - Viability, Safety, and Efficacy of Intrathecal Wharton's Jelly Mesenchymal Stem Cells and Transcutaneous Spinal Cord Stimulation in Chronic Spinal Cord Injury Rehabilitation

NCT ID: NCT06981338

Last Updated: 2025-05-25

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

NOT_YET_RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-01

Study Completion Date

2028-12-31

Brief Summary

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This clinical trial primarily aims to evaluate the safety and feasibility of a combined therapeutic approach for chronic spinal cord injury (SCI). The study will investigate whether the combination of intrathecal Wharton's jelly mesenchymal stem cells and transcutaneous spinal cord stimulation (tSCS) is safe and viable in individuals with chronic traumatic SCI.

The trial will enrol 10 participants aged 16-70 with traumatic SCI (cervical or thoracic levels C1-T12) classified as ASIA Impairment Scale A-C, who are 1-5 years post-injury. Participants will receive three intrathecal injections of Wharton's jelly mesenchymal stem cells, each containing 30 million viable cells (±30%), administered intrathecally at the L3-L4 level. This cellular therapy will be combined with transcutaneous spinal cord stimulation and intensive neurorehabilitation.

Participants will undergo comprehensive assessments over a 12-month follow-up period to monitor safety, feasibility, and secondarily to evaluate potential improvements in motor, sensory, and autonomic functions. Additional annual follow-up will continue for 2 years after study completion to evaluate long-term safety.

Detailed Description

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Conditions

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Spinal Cord Injuries (SCI) Spinal Cord Injury Traumatic Spinal Cord Injuries Spinal Cord Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

This single-arm, open-label pilot study combines intrathecal Wharton's jelly mesenchymal stem cells (3 doses of 30×10⁶±30% cells at 6week-intervals) with transcutaneous spinal cord stimulation (tSCS) in chronic SCI patients (AIS A-C, 1-5 years post-injury). The model evaluates:

* Safety (AEs, neurological/immunological monitoring)
* Feasibility (adherence/retention rates)
* Efficacy signals (motor/sensory/autonomic improvements via ASIA, neurophysiological tests).
* All participants receive active treatment with 12-month core follow-up + 2-year extended safety monitoring.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Allogeneic WJ-MSCs + tSCS-Assisted Neurorehabilitation

All participants receive three intrathecal doses of allogeneic Wharton's jelly mesenchymal stem cells (30×10⁶±30% viable cells/dose) at 6-week intervals, combined with transcutaneous spinal cord stimulation (tSCS)-assisted neurorehabilitation.

Group Type EXPERIMENTAL

Allogeneic Wharton's jelly mesenchymal stem cells (WJ-MSCs)

Intervention Type COMBINATION_PRODUCT

This experimental treatment combines intrathecal administration of allogeneic Wharton's jelly mesenchymal stem cells (WJ-MSCs) with transcutaneous spinal cord stimulation (tSCS) and neurorehabilitation. Participants will receive three doses of cryopreserved WJ-MSCs (30×10⁶±30% viable cells per dose) derived from umbilical cord tissue, delivered via lumbar puncture at 6-week intervals in a saline-albumin solution. The intervention includes concurrent tSCS, a non-invasive electrical stimulation technique, paired with standardised neurorehabilitation. As the first clinical study evaluating this specific combined therapy for chronic spinal cord injury (AIS A-C grades), safety monitoring incorporates regular cerebrospinal fluid analysis to assess potential immune responses.

Interventions

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Allogeneic Wharton's jelly mesenchymal stem cells (WJ-MSCs)

This experimental treatment combines intrathecal administration of allogeneic Wharton's jelly mesenchymal stem cells (WJ-MSCs) with transcutaneous spinal cord stimulation (tSCS) and neurorehabilitation. Participants will receive three doses of cryopreserved WJ-MSCs (30×10⁶±30% viable cells per dose) derived from umbilical cord tissue, delivered via lumbar puncture at 6-week intervals in a saline-albumin solution. The intervention includes concurrent tSCS, a non-invasive electrical stimulation technique, paired with standardised neurorehabilitation. As the first clinical study evaluating this specific combined therapy for chronic spinal cord injury (AIS A-C grades), safety monitoring incorporates regular cerebrospinal fluid analysis to assess potential immune responses.

Intervention Type COMBINATION_PRODUCT

Other Intervention Names

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Transcutaneous spinal cord stimulation (tSCS)

Eligibility Criteria

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Inclusion Criteria

* Individuals aged 16-70 years (parental consent required for 16-18-year-olds)
* Single traumatic spinal cord injury (AIS A-C) at C1-T12 levels
* Chronic injury (1-5 years post-injury)
* Stable medical condition with life expectancy \>2 years
* Ability to attend follow-up visits and comply with all study procedures
* Written informed consent (and parental consent for minors)
* Sufficient cognitive capacity to understand the study
* For women of childbearing potential: use of effective contraception (hormonal, intrauterine device, barrier methods, sterilization, or post-menopausal status \>1 year)

Exclusion Criteria

* Severe comorbidities (e.g., cardiovascular instability, active infections)
* Individuals requiring mechanical ventilation
* Contraindications for tSCS (e.g., implanted devices)
* Pregnancy or breastfeeding
* Neurodegenerative diseases
* Significant haematological/biochemical abnormalities
* Active or recent (≤5 years) malignancy without complete remission
* Positive serology for HIV, hepatitis B virus, hepatitis C virus, or syphilis
* Communication barriers (language, aphasia)
* Concurrent participation in another clinical trial (within 30 days)
* Recent intrathecal medication or immunosuppressants (within 60 days)
* Multi-level spinal lesions or lesions \>3 spinal segments on MRI
* Contraindications for lumbar puncture
* Planned spinal surgery within 24 months
* Inability to participate in rehabilitation
* Known allergies to stem cell preparation components
Minimum Eligible Age

16 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut Guttmann

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Institut Guttmann: Hospital de Neurorehabilitació

Badalona, Barcelona, Catalonia, Spain

Site Status

Countries

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Spain

Central Contacts

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Joan Vidal Samsó, MD, PhD

Role: CONTACT

(+34)934977700

Fernando Martins Braga, MD, MSc

Role: CONTACT

(+34)934977700

Facility Contacts

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Joan Vidal Samsó, MD, PhD

Role: primary

(+34)934977700

Fernando Martins Braga, MD, MSc

Role: backup

(+34)934977700

Other Identifiers

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2025-521877-14-00

Identifier Type: CTIS

Identifier Source: secondary_id

GNR-SCI-01

Identifier Type: -

Identifier Source: org_study_id

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