Epidural and Dorsal Root Stimulation in Humans With Spinal Cord Injury

Peter J. Grahn, Ph.D.

Status: Completed

Conditions: Tetraplegia; Spinal Cord Injuries; Paraplegia; Paralysis

Treatments: Device: Percutaneous epidural and dorsal root stimulation

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04736849

1R01NS115877-01 (U.S. NIH Grant/Contract)

20-006104

Details and patient eligibility

About

A study to compare electrophysiologic activity of epidural stimulation and dorsal root ganglion stimulation, as well as quantify changes in motor performance with both types of stimulation over the course of 10 rehabilitation sessions.

Full description

This study aims to expand the understanding of how electrical spinal stimulation enables function, specifically the pathophysiological mechanisms of action underlying spinal electrical stimulation after SCI, and to address the gap in knowledge of spinal sensorimotor network inputs and outputs generated by spinal electrical stimulation in humans with SCI.

Enrollment: 22 patients

Sex: All

Ages: 22+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Spinal cord injury due to trauma located at or above the tenth thoracic vertebrae
• American Spinal Injury Association grading scale of A, B, C, or D
• Intact spinal reflexes below the level of SCI
• SCI must have occurred at least 1 year prior to study enrollment
• At least 22 years of age
• If female, must be willing to use medically-acceptable method of contraception during study participation

Exclusion criteria

• Currently a prison inmate, or awaiting trial, related to criminal activity
• Pregnancy at the time of screening for trial enrollment
• Active, untreated urinary tract infection
• Unhealed decubitus ulcer
• Unhealed skeletal fracture
• Spinal abnormality that may impede percutaneous implantation of spinal electrodes
• Untreated clinical diagnosis of psychiatric disorder
• Joint contractures that impede typical range of motion
• Non-MRI-compatible implanted medical devices
• Other implanted stimulation devices (e.g. deep brain stimulator, cardiac pacemaker, diaphragmatic pacer, etc.)
• Undergoing, or planning to undergo, diathermy treatment
• Active participation in an interventional clinical trial
• History of clinically-diagnosed cardiopulmonary disorder, such as severe orthostatic hypotension, which may impede participation in rehabilitation activities such as changes in body position such as supine-to-sit-to-stand activities, prolonged standing, or stepping
• History of frequent and/or severe autonomic dysreflexia
• History of seizure disorder
• 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 design

Primary purpose: Basic Science

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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22 participants in 1 patient group

Percutaneous ES and DRS

Experimental group

Description:

Epidural Stimulation (ES) and Dorsal Root Stimulation (DRS) will be delivered via percutaneously implanted electrodes during rehabilitation. All implanted electrodes will be removed at the end of trial participation. The effects of ES and DRS will be recorded via electrophysiological and biomechanical metrics described within the outcomes measures.

Treatment:

Device: Percutaneous epidural and dorsal root stimulation