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治験 NCT06853015(対象:脊髄損傷 (SCI))は募集中です。詳細は治験レーダーのタイル表示と AI 発見ツールで確認するか、ここで質問してください。 | ||
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Double Dose 4-AP on Functional Recovery After Spinal Cord Injury
治験(臨床試験)の詳細は主に英語で提供されています。しかし、治験レーダーAIが支援できます!「治験を説明」をクリックして、選択した言語で試験情報を表示し、議論してください。
治験番号 NCT06853015 は 脊髄損傷 (SCI) に関する 治療 の研究で、第I相・第一段階 第II相・第二段階 介入研究 臨床試験 です。現在は 募集中 で、2025年2月1日 から開始しています。27 名の参加者 の募集が計画されています。この治験は Shirley Ryan AbilityLab によって主催され、2026年3月1日 に完了予定です。ClinicalTrials.gov からの最新更新日は 2025年4月3日 です。
概要
The purpose of this study is to test a strategy to potentiate functional recovery of lower limb motor function in individuals with spinal cord injury (SCI). The FDA approved drug, Dalfampridine (4-AP). 4-AP will be used twice-daily in combination of Spike-timing-dependent plasticity (STDP) stimulation and STDP stimulation with limb training.
詳細説明
Currently, research has shown that 4-AP has a positive effect on sensory and motor function rehabilitation in humans with chronic SCI in addition to decreasing recorded spasticity, increased sensation, and decreased pain. A pharmacokinetic study showed that twice-daily administration of sustained release 4-AP maintains a steadier plasma concentration. Utilizing limb training to promote recovery of motor function is enhanced by eliciting STDP in the limbs. An important strength of this aim is the combination of training and STDP, which aims to enhance the beneficial effects of motor training by promoting plasticity in the corticospinal pathway. Training effects on physiological pathways will be explored and correlated with lower limb motor function. We hypothesize that introducing 4-AP into the STDP stimulation and STDP stimulation with training will further improve motor function rehabilitation in patients with chronic SCI.
公式タイトル
Effects of Twice-daily Dosing 4-AP on Functional Recovery After Spinal Cord Injury
疾患/病気
脊髄損傷 (SCI)その他の研究識別子
- STU00221545
NCT番号
開始日
2025-02-01
最終更新日
2025-04-03
終了予定日
2026-03
目標参加者数
27
試験の種類
介入研究
治験の相・段階
第I相・第一段階
第II相・第二段階
第II相・第二段階
状況
募集中
キーワード
spinal cord injury
neurostimulation
4-AP
rehabilitation
neurostimulation
4-AP
rehabilitation
主目的
治療
割付方法
無作為化
介入モデル
並行割当
盲検化
三重盲検
群(アーム)/介入
| 参加グループ/群 | 介入/治療法 |
|---|---|
実験的4-AP(AM) + STDP stimulation + training + 4-AP(PM) The effects of the functional recovery of the lower-limb muscles will be determined after 40 sessions of twice-daily-dosing 4-AP, STDP stimulation and training. | Dalfampridine The study drug (4-AP) will be administered as a 10 mg dose twice a day. STDP Stimulation Paired stimulation will be given to the spinal cord and to peripheral nerves so that the signals are received at the spinal cord at a specific interval. 運動トレーニング Lower-limb exercises will involve over-ground walking, treadmill, walking and stair climbing training. |
プラセボ対照薬Placebo(AM) + STDP stimulation + training + Placebo(PM) The effects of the functional recovery of the lower-limb muscles will be determined after 40 sessions of twice-daily-dosing Placebo, STDP stimulation and training. | プラセボ The placebo provided by the SRAL pharmacy that looks identical to the 4-AP, will be administered twice a day. STDP Stimulation Paired stimulation will be given to the spinal cord and to peripheral nerves so that the signals are received at the spinal cord at a specific interval. 運動トレーニング Lower-limb exercises will involve over-ground walking, treadmill, walking and stair climbing training. |
主要評価項目
副次評価項目
| 評価指標 | 指標の説明 | 時間枠 |
|---|---|---|
Change in TMEPs | Electrical stimulation will be performed placing the cathode on the upper thoracic between the spinal processes between T3 and T4 vertebrae and the anode at \~10 cm above | TMEPs measured at baseline, at 6 weeks (post 20 sessions), and at 12 weeks (post 40 sessions). |
Change in MVC | Individuals will perform a maximum voluntary contraction (MVC) of each targeted muscle (quadriceps femoris, tibialis anterior or soleus) through surface electrodes secured to the skin over the belly of each muscle. Ankle flexion torque will be measured by measured by force sensors. | MVC measured at baseline, at 6 weeks (post 20 sessions), and at 12 weeks (post 40 sessions). |
| 評価指標 | 指標の説明 | 時間枠 |
|---|---|---|
Change in 10-meter walk test | We will use the 10-meter walk test to quantify walking speed in meters per second. The same percentage of body-weight support will be used during pre- and post-assessments. Less time to walk 10-meter indicates better outcome. | 10-m walk measured at baseline, at 6 weeks (post 20 sessions), and at 12 weeks (post 40 sessions). |
Change in 6-minute walk test | We will measure the distance walked over 6 minutes. The same percentage of body-weight support will be used as in 10-meter walk test. The longer distance walked during 6 minutes indicates better outcome. | 6-min walk measured at baseline, at 6 weeks (post 20 sessions), and at 12 weeks (post 40 sessions). |
Change in International Standards for Neurological Classification of Spinal Cord Injury exam | Motor part of the exam is completed through the testing of key muscle functions corresponding to 10 myotomes (C5-T1 and L2-S1) for right and left side separately. The strength of each muscle function is graded on a six-point scale ranging from 0 meaning complete paralysis to 5 meaning full strength. The total motor score is sum of all motor scores range from 0-100. Sensory part of the exam is completed through the testing of a key point in each of the 28 dermatomes (from C2 to S4-5) on the right and left sides of the body. At each of these key points, two aspects of sensation are examined: light touch and pin prick. Appreciation of light touch and pin prick sensation at each of the key points is separately scored on a three-point scale; 0-absent, 1-altered, and 2-normal or intact. 56 is the maximum score for both light touch and pin prick and the total sensory score ranges from 0 to 112. Higher scores represent better outcome for motor and sensory scores. | Scores measured at baseline, at 6 weeks (post 20 sessions), and at 12 weeks (post 40 sessions). |
Change in EPT | We use electrical perceptual threshold (EPT) to measures the minimum amount of electrical current that the participant can perceive when applied to the lower limb dermatomes (L2-S2). | EPT will be measured at baseline, at 6 weeks (post 20 sessions), and at 12 weeks (post 40 sessions). |
Change in surveys on ambulation, basic mobility, bowel and bladder management difficulties | The name of the questionnaire is Spinal Cord Injury Quality of Life (SCI-QOL) and we used four subdomains: ambulation, self-care, bowel management difficulties, and bladder management difficulties. Scores on all subdomains of SCI-QOL use a standardized T metric, with a mean of 50 and a standard deviation of 10. Ambulation and basic mobility subdomains assess the ability to engage in walking activities in different locations that vary based on speed, time and condition and the ability to manage stairs under different conditions. Bowel management difficulties subdomain measures an ability to carry out a bowel program; concerns about incontinence and bowel accidents; and the impact of bowel management on everyday living. Bladder management difficulties subdomain measures ability to carry out a bladder program; worry about bladder accidents; concerns about implementing one's bladder program; and impact on everyday living. Higher scores on all subdomains represent better outcome. | SCI-QOL measured at at baseline, at 6 weeks (post 20 sessions), and at 12 weeks (post 40 sessions). |
Change in morphological characterization of corticospinal and reticulospinal pathways in MRI | In order to identify descending motor tract, brainstem and C2 cervical spinal cord images will be acquired on a MAGNETOM Prisma 3T system using a 64-channel birdcage head/neck coil. To quantify the effect of atrophy in oblique directions, we will measure the radius from the cord shape center of mass to its border, R(α), for angles α over the whole circle with an angular resolution of 6°. Mean measures of all 5 axial slices will be used for statistical from nerve roots, noise, and other confounding effects. | MRI measured at baseline, and at 12 weeks (post 40 sessions). |
適格基準
対象年齢
成人, 高齢者
試験の最低年齢
18 Years
対象性別
全て
- Male and females between ages 18-85 years
- SCI 6 months post injury
- Spinal Cord injury at or above L2
- ASIA A, B, C, or D, complete or incomplete
- The ability to perform a small visible contraction with dorsiflexion and hip flexor muscles
- Uncontrolled medical problems including pulmonary, cardiovascular or orthopedic disease
- Any history of renal impairment
- Any debilitating disease prior to the SCI that caused exercise intolerance
- Premorbid, ongoing major depression or psychosis, altered cognitive status
- History of head injury or stroke
- Vascular, traumatic, tumoral, infectious, or metabolic lesion of the brain, even without history of seizure, and without anticonvulsant medication
- History of seizures or epilepsy
- Receiving drugs acting primarily on the central nervous system, which lower the seizure threshold (see appendix 2)
- Pregnant females
- If a women of child bearing age is unsure of the pregnancy, and does not want to take the pregnancy test
- Ongoing cord compression or a syrinx in the spinal cord or who suffer from a spinal cord disease such as spinal stenosis, spina bifida, MS, or herniated disk
- Metal plate in skull
- Individuals with scalp shrapnel, cochlear implants, or aneurysm clips
- Individuals taking Bupropion, Dolutegravir, Lacosamide, Trilaciclib, or PR Interval prolonging drugs
責任者
Monica Perez, 研究責任者, Scientific Chair, Shirley Ryan AbilityLab
試験中央連絡先
連絡先: Monica Perez, PT, PhD, 312-238-2886, [email protected]
連絡先: Bing Chen, PhD, 312-238-7895, [email protected]
1 1カ国の場所
Illinois
Shirley Ryan Abilitylab, Chicago, Illinois, 60611, United States
Monica Perez, PT, PhD, 連絡先, 312-238-2886, [email protected]
募集中