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ParaplegiaNCT05095454

Short-Term Transcutaneous or Epidural Spinal Stimulation for Enabling Motor Function in Humans With SCI

A study testing Percutaneous epidural electrical spinal stimulation and Transcutaneous electrical spinal stimulation in people with Paraplegia and Tetraplegia, run by Kristin Zhao, PhD at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A study comparing short-term delivery of epidural spinal stimulation versus transcutaneous spinal stimulation. Read more about this study

Who is it for?
Ages 22 years and older
Conditions the study is for
Paraplegia, Tetraplegia, Paralysis
What is being tested?
Percutaneous epidural electrical spinal stimulation and Transcutaneous electrical spinal stimulation
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
6 participants
Where
1 siteUnited States
Study dates
4 Mar 2022to 30 Mar 2023
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 22 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Spinal cord injury due to trauma located at or above the tenth thoracic vertebrae (T10)
  • American Spinal Injury Association grading scale of A-D (2 from each) below the level of SCI
  • Intact spinal reflexes below the level of SCI
  • At least 1-year post-SCI
  • At least 22 years of age
  • Willing to use medically acceptable methods of contraception, if female and of child-bearing potential

Who cannot join

  • Currently a prison inmate, or awaiting trial, related to criminal activity
  • Pregnancy at the time of enrollment
  • History of chronic and/or treatment resistant urinary tract infection
  • Unhealed decubitus ulcer
  • Unhealed skeletal fracture
  • Untreated clinical diagnosis of depression
Show all 16Show fewer
  • Undergoing, or planning to undergo, diathermy treatment
  • Active participation in another interventional clinical trial
  • Presence of conditions or disorders which require MRI monitoring
  • A history of coagulopathy or other significant cardiac or medical risk factors for surgery
  • Current use of a ventilator
  • Clinically diagnosed cardiopulmonary complications such as chronic obstructive pulmonary disease, cardiac failure, or heart arrhythmia that contraindicate changes in body position such as supine-to-sit-to-stand activities, prolonged standing, or stepping
  • History of frequent hypotension characterized by light headedness, or loss of consciousness
  • History of frequent hypertension characterized by headache, or bradycardia
  • History of frequent, severe, autonomic dysreflexia
  • Any illness or condition which, based on the research team's assessment, will compromise with the patient's ability to comply with the protocol, patient safety, or the validity of the data collected during this study.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Mayo Clinic

    Rochester, Minnesota, 55905

Other trials in United States

About this study

Official title: A Pilot Study to Compare Short-Term Transcutaneous or Epidural Spinal Stimulation for Enabling Motor Function in Humans With Spinal Cord Injury

A study comparing short-term delivery of epidural spinal stimulation versus transcutaneous spinal stimulation.

Read the detailed description

The purpose of this study is to compare spinal motor nerve response to electrical stimulation delivered directly to the epidural space, and delivered through the skin (transcutaneously), and to measure any changes in motor performance over the course of about 5 months, during and after using one of the two types of stimulation.

Being tested
Percutaneous epidural electrical spinal stimulation, Transcutaneous electrical spinal stimulation
Medical subject headings
Paraplegia, Quadriplegia, Paralysis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Percutaneous epidural electrical spinal stimulationDevice

    Abbott percutaneous trial lead for epidural neurostimulation (Model 3086)

    Ripple Neuromed Nomad Neurostimulation System

  • Transcutaneous electrical spinal stimulationDevice

    Digitimer DS8R Bipolar Constant Current Stimulator

Study groups in NCT05095454
Study groupRoleWhat they receive
Percutaneous Epidural StimulationExperimentalEpidural spinal stimulation will be delivered via percutaneously implanted electrodes during rehabilitation. All implanted electrodes will be removed at the end of trial participation. The effects of epidural stimulation will be recorded via electrophysiological and biomechanical metrics described within the outcomes measures.
Receives: Device: Percutaneous epidural electrical spinal stimulation
Transcutaneous Epidural StimulationExperimentalTranscutaneous spinal stimulation will be delivered via skin surface-level electrodes during rehabilitation. The effects of transcutaneous stimulation will be recorded via electrophysiological and biomechanical metrics described within the outcomes measures.
Receives: Device: Transcutaneous electrical spinal stimulation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Electromyography

    Change in voltage measurements in major muscle groups below the level of injury. Specifically, change in soleus root mean square voltage during standing with and without stimulation.

    Measured: Through study completion; an average of 5 months.

  2. Foot Pressure

    Change in measurements of foot pressure in kilograms through shoe-insole pressure sensors.

    Measured: Beginning of intervention to end of intervention, an average of 17 days.

  3. Somatosensory Evoked Potentials

    Measurements of change in voltage in the conduction of electricity through the peripheral nerves, cervical and lumbosacral spinal cord, deep brain structures, and sensory cortex, using surface electrodes.

    Measured: Assessed at Baseline, 4 Weeks, 8 Weeks, and 20 Weeks; change from Baseline at week 20 reported.

  4. Transcranial Magnetic Stimulation Motor Evoked Potentials

    Measurement of the threshold percentage change in voltage between pre-intervention and post-intervention in the first trapezius or deltoid muscle activated.

    Measured: Assessed at Baseline, 4 Weeks, 8 Weeks, and 20 Weeks; change from Baseline at week 20 reported.

  5. Injury Severity: International Standards for Neurological Classification of Spinal Cord Injury

    Change sensory and motor function impairment using the American Spinal Injury Association Impairment Scale. Individuals are classified from A" (complete SCI) to "E" (normal function). 28 dermatomes and 10 key muscles are assessed bilaterally. Summed results produce overall sensory and motor scores and combine with evaluation of anal sensory and motor function in determination of AIS classification. Sensory scores are rated 0 (sensation absent) to 2 (normal), bilaterally for each of 28 dermatomes. Muscle function is rated 0 (total paralysis) to 5 (active movement, full range of motion against significant resistance) for each myotome. Upper Extremity Motor Subscores and Lower Extremity Motor Subscores are scored from 0 to 50; the ASIA Motor Score is scored from 0 to 100. The presence of deep anal pressure and voluntary anal contraction are assessed as a yes/no; absence of these, in addition to sensory scores of 0 at S4-5 indicate a Complete injury (otherwise, the injury is Incomplete).

    Measured: Assessed at Baseline, 4 Weeks, 8 Weeks, and 20 Weeks; change from Baseline at week 20 reported.

  6. Patient-reported Bowel Function

    Measurement of change in bowel function using the Neurogenic Bowel Dysfunction Score. Answers to qualitative questions are rated from 0 to 5, with a higher number indicating more problematic symptoms, and totaled for a score which categorizes severity of neurogenic bowel symptoms. The total score ranges between 0 and 44 points. A higher total score indicates more severe bowel symptoms.

    Measured: Assessed at Baseline, 4 Weeks, 8 Weeks, and 20 Weeks; change from Baseline at week 20 reported.

  7. Patient-reported Bladder Function

    Measurement of change in bladder function using the Neurogenic Bladder Symptom Score. Answers to qualitative questions are rated from 0 to 5, with a higher number indicating more problematic symptoms, and totaled for a score which categorizes severity of neurogenic bladder symptoms. The total score can range from 0 (no symptoms at all) to 74 (maximum symptoms).

    Measured: Assessed at Baseline, 4 Weeks, 8 Weeks, and 20 Weeks; change from Baseline at week 20 reported.

  8. Male Patient-reported Sexual Function (1)

    Measurement of change in erectile dysfunction using the Sexual Health Inventory for Men (SHIM). Answers to qualitative questions are rated from 0 to 5, with a higher number indicating better erectile function, and totaled for a score which categorizes severity of erectile dysfunction. Total score can range from 1 to 25, with a lower number indicating more severe erectile dysfunction.

    Measured: Assessed at Baseline, 4 Weeks, 8 Weeks, and 20 Weeks; change from Baseline at week 20 reported.

  9. Male Patient-reported Sexual Function (2)

    Measurement of change in erectile dysfunction using the International Index for Erectile Function (IIEF). Answers to qualitative questions are rated from 0 to 5, with a higher number indicating better erectile function, and totaled for a score which categorizes severity of erectile dysfunction. Total scores range from 5 to 25, with a lower score indicating more severe erectile dysfunction.

    Measured: Assessed at Baseline, 4 Weeks, 8 Weeks, and 20 Weeks; change from Baseline at week 20 reported.

  10. Female Patient-reported Sexual Function

    Measurement of change in sexual function using the Female Sexual Function Index (FSFI). Answers to qualitative questions are rated from 0 to 5, with a higher number indicating better sexual function, and totaled for a score which categorizes severity of sexual dysfunction.

    Measured: Assessed at Baseline, 4 Weeks, 8 Weeks, and 20 Weeks; change from Baseline at week 20 reported.

  11. Spasticity

    Change in measurements of spasticity using the Spinal Cord Injury Spasticity Evaluation Tool (SCI-SET). Answers to qualitative questions are rated from -3 to +3, with a higher positive number indicating more helpful symptoms, and a lower negative number indicating more problematic symptoms. Questions may also be answered as not applicable (N/A), which do not generate a score. Scores are totaled for a score which categorizes the overall positive or negative impact of a subject's spasticity symptoms. Total score can range from -105 (negative impact) to +105 (positive impact), and the score is averaged by total positive or negative score divided by the number of applicable answers.

    Measured: Assessed at Baseline, 4 Weeks, 8 Weeks, and 20 Weeks; change from Baseline at week 20 reported.

  12. Neurostimulation User Experience

    Rating of the subject's perception of individual aspects of spinal stimulation using the User Experience Questionnaire (UEQ), a survey including 26 descriptive terms and their antonyms. A scoring scale ranging from 1 to 7 determines how closely the subject feels the term or its antonym applies to the intervention, with lower numbers indicating agreement with the term, and higher numbers indicating agreement with the antonym. The terms and antonyms describe a positive and negative perception of each item.

    Subscales grouping terms into like categories average scores into a 7 point range from -3 to +3, with negative averages associated with negative perceptions, and positive averages associated with positive perceptions.

    Measured: End of intervention, an average of 4 weeks

  13. Overground Ambulation [as Appropriate to the Subject]

    Measurement of changes in overground mobility as measured by the Modified 6 Minute Walk Test. Trainers will assess the distance in meters which the subject can cover in 6 minutes, with a greater distance characterizing better overground mobility.

    Measured: Baseline, 4 Weeks, 8 Weeks, and 20 Weeks

  14. Trunk Stability

    Changes in trunk stability based on stable forward reach measured in centimeters, with a greater distance of forward reach characterizing greater trunk stability. Specifically, change in forward reach at the end of the study when comparing stimulation assisted reach and non-stimulation assisted reach.

    Measured: Beginning of intervention to end of intervention, an average of 17 days, 8 weeks post beginning of intervention, 20 weeks post beginning of intervention; change from beginning of intervention at week 20 reported.

  15. Neurostimulator Lead Location and Migration [Epidural Group Only]

    Evaluation of current array location via CT.

    Measured: Pre-intervention and 4 weeks post-intervention

  16. Bladder Function Testing

    Change in measurements of bladder function (end fill detrusor value) utilizing a urodynamic test consisting of a filling phase and a voiding phase cystometrogram along with perineal patch muscle electromyography.

    Measured: Beginning of study, prior to initiating intervention; End of 4 weeks of intervention.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Oct 2021
  2. Study start4 Mar 2022
  3. Primary completion30 Mar 2023
  4. Study completion30 Mar 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
6 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05095454
Sponsor's protocol ID
21-006340
Status last verified
Jun 2024
First submitted
3 Oct 2021
Last updated
9 Jul 2024
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Soong C, Veith DD, Gill ML, Beck LA, Block JB, Asp AJ, Fernandez KA, Linde MB, Mills CJ, Scrabeck TL, Jahanian O, Grahn PJ, Zhao KD, Solinsky R. Off-target effects of percutaneous epidural spinal cord and dorsal root ganglion stimulation with task-specific training on lower urinary tract function in individuals with chronic spinal cord injury. J Spinal Cord Med. 2026 Aug 20:1-12. doi: 10.1080/10790268.2026.2703371. Online ahead of print.

    PubMed 42622482
  • Veith DD, Gill ML, Beck LA, Whitmarsh CL, Fernandez KA, Linde MB, Asp AJ, Mills CJ, Bendel MA, Grahn PJ, Zhao KD. Functional outcomes and participants' perspectives during short-term application of spinal stimulation in individuals with spinal cord injury. J Spinal Cord Med. 2025 Nov;48(6):978-989. doi: 10.1080/10790268.2024.2383377. Epub 2024 Aug 22.

    PubMed 39172032

Questions about this trial

What is this clinical trial studying?

A study testing Percutaneous epidural electrical spinal stimulation and Transcutaneous electrical spinal stimulation in people with Paraplegia and Tetraplegia, run by Kristin Zhao, PhD at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Jul 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Electromyography (time frame: Through study completion; an average of 5 months.). The study lists 16 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05095454, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jul 2024.

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