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PAS in Subacute SCI

Not Applicable
Completed
Conditions
Spinal Cord Diseases
Spinal Cord Injuries
Interventions
Device: Sham paired associative stimulation
Device: Paired associative stimulation
Registration Number
NCT04101916
Lead Sponsor
Helsinki University Central Hospital
Brief Summary

The investigators have recently shown in incomplete SCI patients that long-term paired associative stimulation is capable of restoring voluntary control over some paralyzed muscles and enhancing motor output in the weak muscles. In this study, the investigators will administer long-term paired associative stimulation to patients with incomplete cervical level SCI at the subacute stage, and investigate its effectiveness for upper extremity rehabilitation.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
18
Inclusion Criteria
  1. SCI caused by an external trauma or SCI caused by nontraumatic non-progressive disease of the spinal cord
  2. Cervical level injury, tetraplegia
  3. Time from injury/onset of symptoms 1-4 months
  4. Medical condition stable
  5. Residual neural connectivity in upper extremity: some voluntary activity in finger muscles or MEPs obtainable from distal hand muscles
Exclusion Criteria
  1. Diagnosed brain damage, visible in MRI or CT.
  2. No activity in hands/fingers and no MEPs recorded from distal hand muscles.
  3. Epilepsy
  4. Metal inclusion in the head area
  5. High intracranial pressure
  6. Pacemaker
  7. Implanted hearing device
  8. Progressive diseases of spinal cord or brain (e.g. malignant tumors, degenerative diseases).
  9. History of malignant tumor within the past 5 years.
  10. Previous head or spinal cord injury affecting the motor performance of upper extremities.
  11. Congenital anomaly in the anatomical structure of spinal canal/cord or dura.
  12. Significant systemic disease or other condition that could cause neurological deficit, or may affect subject's capability to undergo investigation-related procedures.
  13. Acute severe infection.
  14. Contraindications for MRI.
  15. Current severe psychiatric diseases.
  16. Current chronic drug and/or alcohol abuse.
  17. Pregnancy.
  18. Severe emergency care polyneuropathy
  19. Pressure ulcer affecting the subject's capability to undergo the procedure safely

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ShamSham paired associative stimulation-
Paired Associative StimulationPaired associative stimulation-
Primary Outcome Measures
NameTimeMethod
Daniels and Worthingham's Muscle TestingChange from baseline score immediately after, 6 months after and 1 year after last stimulation session

hand muscle strength is evaluated on 0-5 scale (0=no movement, 5=normal)

Spinal Cord Independence Measure (SCIM)Change from baseline score immediately after, 6 months after and 1 year after last stimulation session

standard SCIM evaluation

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

BioMag laboratory, Helsinki University Central Hospital

🇫🇮

Helsinki, Uusimaa, Finland

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