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Spinal Cord InjuriesNeuroSCSNCT05926843

Spinal Cord Stimulation Assisted by Motor Rehabilitation Training for Restoring Motor Function After Spinal Cord Injury

A study testing Spinal cord stimulation surgery (device) and motor rehabilitation in people with Spinal Cord Injuries, run by IRCCS San Raffaele at 1 site in Italy.

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

Interventional prospective longitudinal on the evaluation of spinal cord stimulation (SCS) assisted by motor rehabilitation training for restoring motor function in patients with spinal cord injury (SCI). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Spinal Cord Injuries
What is being tested?
Spinal cord stimulation surgery (device) and motor rehabilitation
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteItaly
Study dates
19 Apr 2023to 1 Jul 2026
Phase
Interventional
Are there results?
None posted in the registry

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

Who may be able to join

  • Diagnosis of SCI from at least one-year post injury;
  • Complete or incomplete spinal cord damage (ASIA grade A, B or C) conditioning chronic neuropathic pain and motor impairment
  • Age > 18 years;
  • Indication to spinal cord stimulation surgery for chronic pain;
  • Be unable to stand or step independently;
  • No current anti-spasticity medication regimen;
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  • No botox injections in the prior 3 months;
  • Evidence of a personally signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study;
  • Willingness and ability to comply with scheduled visits and other trial procedures.

Who cannot join

  • Any person unable to lie still within the environment of the MRI scanner for the required period to perform the study and those where MRI scanning is contraindicated (i.e. metal clips, claustrophobia);
  • Pregnancy or breastfeeding;
  • Any significant psychiatric disease;
  • Use of illicit drugs;
  • Unstable medical condition without cardiopulmonary disease or dysautonomia that would contraindicate standing or stepping;
  • Painful musculoskeletal dysfunction, unhealed fracture, contracture, pressure sore, or urinary tract infection that might interfere with stand or step training;

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • IRCCS Ospedale San Raffaele

    Milan, 20132

Other trials in Italy

About this study

Official title: Evaluation of Spinal Cord Stimulation Assisted by Motor Rehabilitation Training for Restoring Motor Function After Spinal Cord Injury: an Interventional, Prospective, Monocentric Study

Interventional prospective longitudinal on the evaluation of spinal cord stimulation (SCS) assisted by motor rehabilitation training for restoring motor function in patients with spinal cord injury (SCI). The investigators will enroll ten research participants with clinically incomplete/complete SCI (patients with paraplegia or severe paraparesis) who will undergo SCS subsequently assisted by motor rehabilitation training for restoring motor function at IRCCS Ospedale San Raffaele, Milan, Italy. The main goal of the project is to evaluate the improvement in motor function generated by the combination of SCS and locomotor training. In line with recently published studies, the investigators propose that daily locomotor training in the presence of SCS with continuous stimulation parameters setting will enable the SCI individuals to stand and step independently while bearing full weight.

Being tested
Spinal cord stimulation surgery (device) and motor rehabilitation
Keywords
motor restoration, chronic pain, rehabilitation, neuromodulation
Medical subject headings
Spinal Cord Injuries, Chronic Pain

What participants receive

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

  • Spinal cord stimulation surgery (device) and motor rehabilitationProcedure or surgery

    The first part of the study will involve a preoperative evaluation. Participants' clinical history, neurological, neurophysiological and advanced brain/spine MRI examination will be assessed (Part 1). Subsequently, participants will undergo spinal cord stimulation surgery which involves the implantation of a medical device (Part 2). After the surgery, the research participants will be hospitalized at the Neurosurgery Unit (10 days) to monitor the incision site (Part 3). Thereafter, the patients will be moved (for at least 6 weeks) to the Rehabilitation Unit in order to identify appropriate stimulation parameters for inducing stepping and standing and for starting training. The combination of epidural stimulation with manual step/stand training will be thus evaluated (Part 4). Patients will be finally assessed by clinical evaluation, advanced MRI and neurophysiological examination to study the brain, spine and peripheral functions after six months (Part 5).

Study groups in NCT05926843
Study groupRoleWhat they receive
Individuals with functionally complete/incomplete spinal cord injuryExperimentalIndividuals with functionally complete/incomplete spinal cord injury (ASIA grade A, B or C) who will undergo SCS for chronic pain
Receives: Procedure: Spinal cord stimulation surgery (device) and motor rehabilitation

What is being measured

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

  1. Motor changes (MRC)

    The Medical Research Council's (MRC) scale of muscle power will be used to evaluate motor weakness. The MRC scale of muscle strength uses a score from Grade 5 (normal) to Grade 0 (no visible contraction) to assess the power of a particular muscle group in relation to the movement of a single joint.

    Measured: Before surgery, then monthly up to 6-month from surgery

  2. Motor changes (LEFS))

    The Lower Extremity Functional Scale (LEFS) will be used by clinicians as a measure of lower extremity function. It is a questionnaire containing 20 questions about a person's ability to perform everyday tasks (minimum score 0, maximum score 80).

    Measured: Before surgery, then monthly up to 6-month from surgery

  3. Hand-held dynamometry

    Quantitative assessment of maximal voluntary isometric muscle force. Measurements were performed only in muscles reaching MRC grade ≥3, corresponding to active movement against gravity. The measured outcome was the maximal force generated during isometric contraction.

    Measured: From enrollment to the end of treatment at 6 months

  4. IMU-based single-joint assessment

    Quantitative kinematic assessment of isolated lower-limb movements using wearable inertial measurement units (IMUs). The measured outcomes were the peak hip flexion angle and peak knee extension angle during stimulation-assisted single-joint movements.

    Measured: From enrollment to the end of treatment at 6 months

  5. Standing assessment

    Functional evaluation of upright standing ability. Standing performance was quantified by:

    • duration of maintained standing (minutes);
    • percentage of body weight supported through the lower limbs, measured using a stabilometric platform.

    Measured: From enrollment to the end of treatment at 6 months

  6. Overground walking

    10-Meter Walking Test (10MWT). Standardized assessment of walking speed over a 10-meter distance. The measured outcome was the time required to complete the test, from which walking speed can be derived. In motor-incomplete participants the test was performed in the OFF condition whenever feasible, whereas motor-complete participants were assessed during active stimulation.

    Six-minute walk test (6MWT). Standardized assessment of walking endurance. The measured outcome was the total distance walked over six minutes. Motor-incomplete participants were assessed in the OFF condition whenever feasible, whereas motor-complete participants performed the test during active stimulation.

    Measured: From enrollment to the end of treatment at 6 months

Secondary outcomes (9)
  1. Spasticity changes

    The Modified Ashworth scale will be used to evaluate spasticity. This scale grades the muscle tone from 0 (normal) to 4 (severe spasticity).

    Measured: Before surgery, then monthly up to 6-month from surgery

  2. Longitudinal neurophysiological reorganization (electromyography)

    Electromyography will be used to evaluate muscle response or electrical activity in response to a nerve's stimulation.

    Measured: Before surgery and 6 months after procedure

  3. Longitudinal neurophysiological reorganization (motor evoked potentials)

    Motor evoked potentials will be used to evaluate electrical signals recorded from the descending motor pathways or from muscles following stimulation of motor pathways within the brain.

    Measured: Before surgery and 6 months after procedure

  4. Longitudinal neurophysiological reorganization (sensory evoked potentials)

    Sensory evoked potentials will be used to assess electrical activity in the brain in response to sensory stimulation.

    Measured: Before surgery and 6 months after procedure

  5. Longitudinal brain and spine MRI reorganization

    Structural and functional brain and spine MRI analysis.

    Measured: Before surgery and 6 months after procedure

  6. Chronic pain changes (MPQ)

    The McGill Pain Questionnaire (MPQ) can be used to evaluate a person experiencing significant pain. It consists of 15 descriptors (11 sensory; 4 affective) which are rated on an intensity scale as 0 = none, 1 = mild, 2 = moderate or 3 = severe.

    Measured: Before surgery and 6 months after procedure

  7. Chronic pain changes (PCS)

    The Pain Catastrophizing Scale (PCS) assesses the extent of catastrophic thinking. It assesses the extent of catastrophic thinking due to low back pain according to 3 components: rumination, magnification, and helplessness. It is a 13-item scale, with a total range of 0 to 52. Higher scores are associated with higher amounts of pain catastrophizing.

    Measured: Before surgery and 6 months after procedure

  8. Chronic pain changes (ASC-12)

    12-item Allodynia Symptom Checklist (ASC-12) evaluates presence of allodynia and hypoesthesia.

    Measured: Before surgery and 6 months after procedure

  9. Functional and neuropsychological assessment

    The WISCI II is used to assess functional status in patients with lower-limb disability; the SCIM to evaluate independence in activities of daily living; and the SF-36 to assess overall health-related quality of life. Mood and emotional status is assessed using the BDI for depressive symptoms and the STAI for anxiety. Apathy was assessed using the IDAS.

    Measured: Before surgery and 6 months after procedure

Timeline

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

  1. First posted3 Jul 2023
  2. Study start19 Apr 2023
  3. Primary completion30 Dec 2025
  4. Study completion1 Jul 2026

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
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05926843
Sponsor's protocol ID
Neuro-SCS-001
Acronym
NeuroSCS
Status last verified
Aug 2026
First submitted
1 Jun 2023
Last updated
26 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Jackson A, Zimmermann JB. Neural interfaces for the brain and spinal cord--restoring motor function. Nat Rev Neurol. 2012 Dec;8(12):690-9. doi: 10.1038/nrneurol.2012.219. Epub 2012 Nov 13.

    PubMed 23147846
  • Sdrulla AD, Guan Y, Raja SN. Spinal Cord Stimulation: Clinical Efficacy and Potential Mechanisms. Pain Pract. 2018 Nov;18(8):1048-1067. doi: 10.1111/papr.12692. Epub 2018 Apr 23.

    PubMed 29526043
  • Seanez I, Capogrosso M. Motor improvements enabled by spinal cord stimulation combined with physical training after spinal cord injury: review of experimental evidence in animals and humans. Bioelectron Med. 2021 Oct 28;7(1):16. doi: 10.1186/s42234-021-00077-5.

    PubMed 34706778
  • Gill ML, Grahn PJ, Calvert JS, Linde MB, Lavrov IA, Strommen JA, Beck LA, Sayenko DG, Van Straaten MG, Drubach DI, Veith DD, Thoreson AR, Lopez C, Gerasimenko YP, Edgerton VR, Lee KH, Zhao KD. Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia. Nat Med. 2018 Nov;24(11):1677-1682. doi: 10.1038/s41591-018-0175-7. Epub 2018 Sep 24.

    PubMed 30250140
  • Angeli CA, Boakye M, Morton RA, Vogt J, Benton K, Chen Y, Ferreira CK, Harkema SJ. Recovery of Over-Ground Walking after Chronic Motor Complete Spinal Cord Injury. N Engl J Med. 2018 Sep 27;379(13):1244-1250. doi: 10.1056/NEJMoa1803588. Epub 2018 Sep 24.

    PubMed 30247091
  • Wagner FB, Mignardot JB, Le Goff-Mignardot CG, Demesmaeker R, Komi S, Capogrosso M, Rowald A, Seanez I, Caban M, Pirondini E, Vat M, McCracken LA, Heimgartner R, Fodor I, Watrin A, Seguin P, Paoles E, Van Den Keybus K, Eberle G, Schurch B, Pralong E, Becce F, Prior J, Buse N, Buschman R, Neufeld E, Kuster N, Carda S, von Zitzewitz J, Delattre V, Denison T, Lambert H, Minassian K, Bloch J, Courtine G. Targeted neurotechnology restores walking in humans with spinal cord injury. Nature. 2018 Nov;563(7729):65-71. doi: 10.1038/s41586-018-0649-2. Epub 2018 Oct 31.

    PubMed 30382197
  • Albano L, Emedoli D, Agnesi F, Romeni S, Losanno E, Toni L, Fossati V, Ciucci C, Gasperotti F, Cociani L, Zucco G, Pompeo E, Mura C, Carpaneto J, Tettamanti A, Castelnovo V, Padul JD, Mandelli C, Barzaghi LR, Alemanno F, Caravati H, Butera C, Del Carro U, Castellano A, Falini A, Agosta F, Filippi M, Iannaccone S, Mortini P, Micera S. Epidural electrical stimulation facilitates motor recovery in spinal cord injury involving the conus medullaris: A case study. Med. 2025 Oct 10;6(10):100706. doi: 10.1016/j.medj.2025.100706. Epub 2025 May 27.

    PubMed 40436013

Questions about this trial

What is this clinical trial studying?

A study testing Spinal cord stimulation surgery (device) and motor rehabilitation in people with Spinal Cord Injuries, run by IRCCS San Raffaele at 1 site in Italy.

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 9 inclusion and 6 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 26 Aug 2026. 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 Italy. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Motor changes (MRC) (time frame: Before surgery, then monthly up to 6-month from surgery). The study lists 6 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 NCT05926843, which also lists 7 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 26 Aug 2026.

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