Deep Anterior Cerebellar Stimulation in Treatment of Poststroke Spasticity and Motor Function Impairment.

NCT ID: NCT07190092

Last Updated: 2025-09-24

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

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-01

Study Completion Date

2028-12-30

Brief Summary

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The aim of this clinical trial is to determine whether deep brain stimulation (DBS) interventions improve rehabilitation and functional recovery in patients with post-stroke spasticity who meet the other inclusion criteria listed below.

Primary question(s) to be answered:

Is DBS stimulation effective in treating post-stroke spasticity? What stimulation frequency is most effective in treating post-stroke spasticity?

Study participants will:

* Undergo surgery to implant a DBS electrode targeting the DRTt (dentate-rubro-thalamic tract ) in close proximity of the dentate nucleus of the cerebellum ipsilateral to the spastic side of the body.
* Each patient will then receive an initial stimulation frequency of 130 Hz (arm 1) and will be assigned to a 4- to 6-week rehabilitation program. After this period, the participant will return for a follow-up visit for a clinical evaluation.
* The frequency will then be changed to 70Hz (arm 2). Patients who have undergone this change will also undergo a rehabilitation period of 4 to 6 weeks. After this period, they will return to the Clinic for a follow-up evaluation.
* The frequency will then be changed to 30Hz (arm 3). Patients who have undergone this change will also undergo a rehabilitation period of 4 to 6 weeks.

Researchers will compare the results obtained from patients in each arm to determine the clinical effects of stimulation and whether they are dependent on the stimulation frequency.

Detailed Description

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Conditions

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Post Stroke Spasticity Dystonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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High-frequency stimulation

Patients in this arm of the study will undergo implantation of deep brain stimulation electrodes. The stimulation parameters will include a frequency of 130 Hz, which differentiates this arm from the others. The study duration will be four weeks. At the beginning and end of participation in this arm, patients will be examined and assessed using the previously discussed scales.

Group Type EXPERIMENTAL

Deep brain stimulation electrode implantation with an electrode target in the dentate nucleus

Intervention Type PROCEDURE

The intervention will involve implantation of a directional electrode with a target in the dentate nucleus of the cerebellum, ipsilateral to the limbs affected by spasticity. Electrode implantation will be performed using a stereotaxic frame, following prior planning of the electrode trajectory and tractography of the dento-ruborothalamic tract using a planning station. The procedure will be performed under general anesthesia. The IPG stimulator will be placed in the subclavicular region.

Low-frequency stimulation

Patients in this arm of the study will have deep brain stimulation electrodes implanted. Stimulation parameters will include a frequency of 50 Hz, which differentiates this arm from the others. The study duration will be four weeks. At the beginning and end of participation in this arm, patients will be examined and assessed using the previously discussed scales.

Group Type EXPERIMENTAL

Deep brain stimulation electrode implantation with an electrode target in the dentate nucleus

Intervention Type PROCEDURE

The intervention will involve implantation of a directional electrode with a target in the dentate nucleus of the cerebellum, ipsilateral to the limbs affected by spasticity. Electrode implantation will be performed using a stereotaxic frame, following prior planning of the electrode trajectory and tractography of the dento-ruborothalamic tract using a planning station. The procedure will be performed under general anesthesia. The IPG stimulator will be placed in the subclavicular region.

No stimulation

Patients participating in this arm of the study will have deep brain stimulation electrodes implanted. The stimulation will be turned off. The study will last four weeks. At the beginning and end of their participation in this arm, patients will be assessed and rated using the scales discussed earlier.

Group Type SHAM_COMPARATOR

Deep brain stimulation electrode implantation with an electrode target in the dentate nucleus

Intervention Type PROCEDURE

The intervention will involve implantation of a directional electrode with a target in the dentate nucleus of the cerebellum, ipsilateral to the limbs affected by spasticity. Electrode implantation will be performed using a stereotaxic frame, following prior planning of the electrode trajectory and tractography of the dento-ruborothalamic tract using a planning station. The procedure will be performed under general anesthesia. The IPG stimulator will be placed in the subclavicular region.

Interventions

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Deep brain stimulation electrode implantation with an electrode target in the dentate nucleus

The intervention will involve implantation of a directional electrode with a target in the dentate nucleus of the cerebellum, ipsilateral to the limbs affected by spasticity. Electrode implantation will be performed using a stereotaxic frame, following prior planning of the electrode trajectory and tractography of the dento-ruborothalamic tract using a planning station. The procedure will be performed under general anesthesia. The IPG stimulator will be placed in the subclavicular region.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* One time stroke that occurred 9-36 months ago
* Ischemic or hemorrhagic stroke
* Spastic paresis of at least one limb
* At least 3 months of poststroke rehabilitation in the past
* No improvement of spasticity/motor function for at least 3 months

Exclusion Criteria

* Seizures after the stroke
* Depression
* Severe sensory deficits
* Anosognosia
* Moderate to severe hemispatial neglect
* Others contraindications for the DBS procedure, e.g. coagulopathy, decompensated chronic disease, etc.
* Contraindication for MRI
* No poststroke rehabilitation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jan Biziel University Hospital No 2 in Bydgoszcz

OTHER

Sponsor Role lead

Responsible Party

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Pawel Sokal

Head of Department of Neurosurgery and Neurology

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Department of Neurosurgery and Neurology University Hospital nr 2 Collegium Medicum Nicolaus Copernicus University

Bydgoszcz, , Poland

Site Status RECRUITING

Countries

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Poland

Central Contacts

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Paweł Sokal, Ph.D.

Role: CONTACT

+48600954415

Facility Contacts

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Paweł Sokal, Ph.D.

Role: primary

+48600954415

Magdalena Jabłońska, M.D.

Role: backup

+48 784 019 156

Other Identifiers

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KB 314/2023

Identifier Type: -

Identifier Source: org_study_id

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