Individualized Neuro-Modulation Paired With Cerebellar Therapy
Purpose
The purpose of this project is to evaluate feasibility and preliminary efficacy of pairing personalized transcranial direct current stimulation (tDCS) with individualized rehabilitation therapy in people with cerebellar damage.
Conditions
- Cerebellar Ataxia
- Cerebellar Diseases
- Cerebellar Stroke
- Cerebellar Tumor
Eligibility
- Eligible Ages
- Between 18 Years and 75 Years
- Eligible Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Age 18-75 years - Males and Females - Disorders that predominantly affect the cerebellum: damage from stroke, tumor or degeneration (genetic or non-genetic causes, congenital hypoplasia).
Exclusion Criteria
- Diagnoses or impairments that interfere with task execution or data interpretation. - Heart pacemaker or other MRI-incompatible implanted metal device - Metallic foreign body in their eye or head - Experience with severe claustrophobia - Experience discomfort from the MRI scan, such as excessive heating of tattoos - Seizures or history of seizure disorder - Alcohol or substance use disorder (self-report) - Diagnosed history of severe psychiatric disorder such as depression, schizophrenia (self-report) - Metallic foreign body in their eye or head (except the mouth e.g. dental fillings) - Specific medications: tricyclic anti-depressants or neuroleptic medication - Any medical condition (including orthopedic, pain, cardiopulmonary or other) that limits safe participation in exercise training
Study Design
- Phase
- N/A
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Intervention Model Description
- All participants will receive exercise therapy. Some will receive active transcranial direct current stimulation and some will receive sham stimulation.
- Primary Purpose
- Treatment
- Masking
- Single (Participant)
- Masking Description
- Participants will be masked in regards to receiving active or sham tDCS.
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Experimental Active stimulation combined with therapy. |
Once a stimulation site is determined, subjects will receive 20 minutes of active tDCS stimulation daily. Subjects will also receive one hour of therapy, twice daily. Therapy will be individualized to each subject and, will encompass three domains; 1) walking and balance control, 2) hand dexterity and arm control, 3)speech articulation, prosody, and intelligibility. Subjects will complete up to 30 therapy sessions. |
|
|
Sham Comparator Sham stimulation combined with therapy. |
Once a stimulation site is determined, subjects will receive 20 minutes of sham tDCS stimulation daily. Subjects will also receive one hour of therapy, twice daily. Therapy will be individualized to each subject and, will encompass three domains; 1) walking and balance control, 2) hand dexterity and arm control, 3)speech articulation, prosody, and intelligibility. Subjects will complete up to 30 therapy sessions. |
|
Recruiting Locations
Baltimore, Maryland 21205
More Details
- Status
- Recruiting
- Sponsor
- Hugo W. Moser Research Institute at Kennedy Krieger, Inc.
Detailed Description
Cerebellar damage causes debilitating ataxia affecting balance, coordination, speech, and cognition. Rehabilitation therapy is the main treatment for ataxia because pharmacological therapeutics are extremely limited. Non-invasive brain stimulation has shown promise in improving motor function and has an excellent safety profile. However, optimal stimulation sites and efficacy when combined with rehabilitation remain unclear. We hypothesize that three weeks of intensive rehabilitation therapy paired with personalized transcranial direct current stimulation (tDCS) will produce greater functional improvements in people with cerebellar damage compared to therapy with sham stimulation. This double-blind, randomized, sham-controlled trial will enroll participants with cerebellar damage. We will determine stimulation sites using multimodal neuroimaging and electric field modeling and then check their response to stimulation. If they show MRI response to stimulation and it is well-tolerated, they will be eligible to receive 30 hours of training (one hour, twice daily), with active or sham tDCS during one of the daily sessions Primary outcomes are the Scale for Assessment and Rating of Cerebellar Ataxia (SARA) and Patient-Reported Outcome Measure of Ataxia (PROM-Ataxia), assessed pre-treatment, post-treatment, and at 3- and 6-month follow-ups. This research addresses a critical gap in treatment options for cerebellar ataxia by testing whether personalized neuromodulation enhances rehabilitation outcomes.