Epidural Stimulation for Spinal Cord Injury
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 100
- 试验地点
- 2
- 主要终点
- Change in Volitional Response Index Magnitude
研究概览
简要总结
This study will evaluate a method to optimize parameter settings in epidural spinal cord stimulation used to recover lower extremity volitional movement. The study will also characterize improvement in autonomic function (such as blood pressure control) and other functions related to spinal cord injury.
详细描述
Epidural spinal cord stimulation for the purpose of facilitating volitional movement is a new and novel neuromodulatory treatment. Epidural SCS has a long history of use for chronic pain with established medical device platforms. The purpose of this study is to investigate and establish the use of SCS for volitional movement. Specifically, establishing the disinhibitory effect of SCS in a greater population with inherent greater variability.
In addition to establishing the disinhibitory effect of SCS for cSCI, our study attempts to explore the parameter space of the spinal cord stimulator platforms in order to optimize stimulation settings for patients through the creation of a clinical decision support system (CDSS). Preliminary evidence suggests benefit to autonomic function, and this study also begins to explore the effects of SCS on cardiovascular function, urinary function, psychiatric outcomes, and quality of life, which all offer significant potential for patients suffering from chronic spinal cord injury.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
盲法说明
Masking is done during formal testing of BMCA
入排标准
- 年龄范围
- 22 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •22 years of age or older
- •Able to undergo the informed consent/assent process
- •Stable, motor-complete paraplegia
- •Discrete spinal cord injury between C6 and T10
- •ASIA A or B Spinal Cord Injury Classification
- •Medically stable in the judgement of the principal investigator
- •Intact segmental reflexes below the lesion of injury
- •Greater than 1 year since initial injury and at least 6 months from any required spinal instrumentation
- •Willing to attend all scheduled appointments
排除标准
- •Diseases and conditions that would increase the morbidity and mortality of spinal cord injury surgery (e.g. cardiopulmonary issues)
- •Inability to withhold antiplatelet/anticoagulation agents perioperatively
- •Significant dysautonomia that would prohibit rehabilitation or assisted standing or any history of CVA or MI associated with autonomic dysreflexia. A single tilt table test with syncope, presyncope, or SBP < 50 or >
- •Other conditions that would make the subject unable to participate in testing/rehabilitation in the judgement of the principal investigator
- •Current and anticipated need for opioid pain medications or pain that would prevent full participation in the rehabilitation program in the judgement of the principal investigator
- •Clinically significant mental illness in the judgement of the principal investigator
- •Botulinum toxin injections in the previous 6 months
- •Volitional movements present during EMG testing in bilateral lower extremities
- •Unhealed spinal fracture
- •Presence of significant contracture
- •Presence of pressure ulcers
- •Recurrent urinary tract infection refractory to antibiotics
- •Current Pregnancy
结局指标
主要结局
Change in Volitional Response Index Magnitude
时间窗: Months: 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15
Brain Motor Control Assessment Volitional Response Index Magnitude
次要结局
- Cerebrovascular Assessment Change(Months: 3, 6, 9)
- Spinal cord stimulation optimization(Over 12 months)
- Spinal cord stimulation for cardiovascular function(Over 12 months)
- Change in Visual Neurocognitive Assessment(Months: 3, 6, 9)