Cervical Transcutaneous SCS for TBI

NCT ID: NCT07147816

Last Updated: 2025-12-02

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

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-26

Study Completion Date

2029-11-01

Brief Summary

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The goal of this study is to test the effects of non-invasive electrical stimulation of the spinal cord (called transcutaneous spinal cord stimulation, or tSCS) on arm and hand movement in people with motor impairments after a traumatic brain injury (TBI). Specifically, tSCS will be delivered using adhesive electrode pads placed on the skin over the upper back. The research team will measure how tSCS affects strength, movement control and muscle spasticity using different tests. Results of this study will help develop future treatments using an implanted (invasive) form of spinal cord stimulation to improve arm and hand function, helping people with TBI become more independent and improve their quality of life.

Detailed Description

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The main goal of this study is to assess the immediate effects of cervical transcutaneous spinal cord stimulation (tSCS) on arm and hand motor functions after traumatic brain injury (TBI). Specifically, the investigators will assess the immediate effects of tSCS across four different axes: arm and hand strength, arm motor control, joint synergies and spasticity.

The study hypothesis is that tSCS can immediately facilitate voluntary motor output of upper limb muscles by modulating residual descending drive to spinal motoneurons in TBI individuals. In this approach, tSCS targets large-diameter sensory fibers projecting onto motor neuron pools of upper limb muscles. Thus, by modulating the activity of these sensory fibers, the investigators hypothesize that tSCS can immediately increase the excitability of motoneurons receiving residual supraspinal input during movement execution.

Upon completion of this study, the investigators expect to build foundational evidence supporting the use of invasive (e.g. epidural spinal cord stimulation) and non-invasive SCS (tSCS) to improve upper limb motor function in individuals affected by chronic motor impairments after TBI. These results will lay the groundwork for future studies aimed at developing SCS neuroprosthetic devices.

Conditions

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Traumatic Brain Injury TBI (Traumatic Brain Injury)

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Prospective, non-randomized, open-label, descriptive, experimental study.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Transcutaneous electrical stimulation of the cervical spinal cord (tSCS)

Group Type EXPERIMENTAL

Transcutaneous electrical stimulation of the cervical spinal cord (tSCS)

Intervention Type DEVICE

All participants enrolled in this group will receive non-invasive transcutaneous electrical stimulation of the cervical spinal cord (tSCS) while performing strength, spasticity and motor control assessment tasks. Researchers will assess the immediate effects of tSCS (within the same experimental session) on arm and hand movements in individuals with motor impairments caused by traumatic brain injury.

Interventions

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Transcutaneous electrical stimulation of the cervical spinal cord (tSCS)

All participants enrolled in this group will receive non-invasive transcutaneous electrical stimulation of the cervical spinal cord (tSCS) while performing strength, spasticity and motor control assessment tasks. Researchers will assess the immediate effects of tSCS (within the same experimental session) on arm and hand movements in individuals with motor impairments caused by traumatic brain injury.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

TRAUMATIC BRAIN INJURY (TBI) SUBJECTS:

* Participants must have a suffered a traumatic brain injury resulting in impairments in arm and hand motor function at least one year prior to enrollment.
* Participants must be between the ages of 21 and 70 years old.

HEALTHY CONTROL SUBJECTS:

* Participants must have full range of motion in their upper limbs;
* Participants must be between the ages of 21 and 70 years old.

Exclusion Criteria

TRAUMATIC BRAIN INJURY (TBI) SUBJECTS:

* Participants with severe behavioral or cognitive impairments (e.g., aphasia, apraxia, visual neglect) that could preclude their ability to participate in the study.
* Participants diagnosed with Paroxysmal Sympathetic Hyperactivity (PSH);
* Participants with post-TBI heterotopic ossification or tendon contractures that restricts passive range of motion of upper limb joints;
* Participants with uncontrolled epilepsy or untreated seizure disorders;
* Participants with implanted electronic devices, such as pacemakers and spinal cord stimulators;
* Participants taking benzodiazepine for spasticity;
* Participants with serious disease or disorder (ex. neurological condition other than TBI, cancer, severe cardiac or respiratory disease, renal failure, etc.) that could affect their ability to participate in this study.
* Female participants must not be pregnant or breast feeding.
* Evaluation to sign consent form score \<12.

HEALTHY CONTROL SUBJECTS:

\- Participants who have any serious disease or disorder (e.g. cancer, severe cardiac or respiratory disease, neurological conditions, etc.) or cognitive impairments that could affect their ability to participate in this study.
Minimum Eligible Age

21 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Chuck Noll Foundation

UNKNOWN

Sponsor Role collaborator

Roberto de Freitas

OTHER

Sponsor Role lead

Responsible Party

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Roberto de Freitas

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Roberto M de Freitas, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Pittsburgh

Locations

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University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Amy Boos, MS

Role: CONTACT

412-648-4179

Roberto M de Freitas, PhD

Role: CONTACT

412-383-1077

Facility Contacts

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Amy Boos, MS

Role: primary

412-648-4179

References

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de Freitas RM, Sasaki A, Sayenko DG, Masugi Y, Nomura T, Nakazawa K, Milosevic M. Selectivity and excitability of upper-limb muscle activation during cervical transcutaneous spinal cord stimulation in humans. J Appl Physiol (1985). 2021 Aug 1;131(2):746-759. doi: 10.1152/japplphysiol.00132.2021. Epub 2021 Jun 17.

Reference Type BACKGROUND
PMID: 34138648 (View on PubMed)

de Freitas RM, Capogrosso M, Nomura T, Milosevic M. Preferential activation of proprioceptive and cutaneous sensory fibers compared to motor fibers during cervical transcutaneous spinal cord stimulation: a computational study. J Neural Eng. 2022 May 17;19(3). doi: 10.1088/1741-2552/ac6a7c.

Reference Type BACKGROUND
PMID: 35472720 (View on PubMed)

Inanici F, Brighton LN, Samejima S, Hofstetter CP, Moritz CT. Transcutaneous Spinal Cord Stimulation Restores Hand and Arm Function After Spinal Cord Injury. IEEE Trans Neural Syst Rehabil Eng. 2021;29:310-319. doi: 10.1109/TNSRE.2021.3049133. Epub 2021 Mar 2.

Reference Type BACKGROUND
PMID: 33400652 (View on PubMed)

Moritz C, Field-Fote EC, Tefertiller C, van Nes I, Trumbower R, Kalsi-Ryan S, Purcell M, Janssen TWJ, Krassioukov A, Morse LR, Zhao KD, Guest J, Marino RJ, Murray LM, Wecht JM, Rieger M, Pradarelli J, Turner A, D'Amico J, Squair JW, Courtine G. Non-invasive spinal cord electrical stimulation for arm and hand function in chronic tetraplegia: a safety and efficacy trial. Nat Med. 2024 May;30(5):1276-1283. doi: 10.1038/s41591-024-02940-9. Epub 2024 May 20.

Reference Type BACKGROUND
PMID: 38769431 (View on PubMed)

Powell MP, Verma N, Sorensen E, Carranza E, Boos A, Fields DP, Roy S, Ensel S, Barra B, Balzer J, Goldsmith J, Friedlander RM, Wittenberg GF, Fisher LE, Krakauer JW, Gerszten PC, Pirondini E, Weber DJ, Capogrosso M. Epidural stimulation of the cervical spinal cord for post-stroke upper-limb paresis. Nat Med. 2023 Mar;29(3):689-699. doi: 10.1038/s41591-022-02202-6. Epub 2023 Feb 20.

Reference Type BACKGROUND
PMID: 36807682 (View on PubMed)

Other Identifiers

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STUDY25060159

Identifier Type: -

Identifier Source: org_study_id

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