CClinicalTrials.gg
CompletedNCT02684201PhantomLimbUpdated Oct 8, 2025Results posted

Epidural Spinal Cord Stimulation for Sensory Restoration and Phantom Limb Pain in Upper-Limb Amputees

An interventional study of Boston Scientific Stimulator Lead in Phantom Limb, sponsored by Lee Fisher, PhD. Completed at 1 site in United States. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2025-10-08.

Sponsored by Lee Fisher, PhD · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
4
Allocation
Not applicable
Ages
18 Years to 70 Years
Sex
All
01

Study summary

Individuals with upper-limb amputation usually have intact nerves within the residual limb, and studies have demonstrated that electrical stimulation of those nerves can produce sensations that appear to emanate from the amputated limb. In this study, investigators will examine the sensations that are produced by electrical stimulation of these nerves at the location where they exit the spinal cord. Stimulation of the spinal cord is commonly used to treat intractable back and limb pain, and the procedure includes a test phase in which electrodes are temporarily placed under the skin near the spinal cord and removed at the end of testing. Similarly, in this study, electrodes will be placed near the spinal cord in the upper back and neck, and stimulation will be applied over the course of multiple testing sessions, lasting less than 30 days. The electrodes will be removed at the last day of testing. During each testing session, electrical stimulation will be applied through the electrodes and a series of tests will be performed to determine the types of sensations produced by stimulation. In addition to producing meaningful sensations with electrical stimulation, this study will also test the effect of stimulation on phantom limb sensations and phantom limb pain.

Read the detailed description

The purpose of this research study is to characterize the types of sensations that can be produced by stimulating the spinal nerves in upper-limb amputees, as well as the effects of that stimulation on phantom limb pain. The study involves a medical procedure to temporarily place one to three stimulation electrodes in the space near the spinal cord. This medical procedure will be performed under local anesthesia, and will take approximately one to two hours. Afterwards, the electrodes will be connected to an external stimulator and a series of experiments will be performed to characterize the types of sensations generated by electrical stimulation of the spinal cord and spinal nerves, as well as to measure the effect of stimulation on phantom limb sensations and phantom limb pain. Over the course of less than 30 days, there will be up to 20 of these experimental sessions. At the end of the final experimental session, the stimulation electrodes will be removed by gently pulling on them.

The investigators are inviting participants to consider participating in this research because they have an upper-limb amputation. Participants must be between the ages of 18 and 70 and at least one year post-amputation. Participants must be willing to travel to the University of Pittsburgh at least twice per week for 30 days.

Participants cannot have any serious diseases or disorders that affect your ability to participate in this study. Women who are pregnant or plan to become pregnant during the study cannot be included. The investigators will ask females of child-bearing potential to undergo a urine pregnancy test prior to any procedures (such as MRI, x-ray, fluoroscopy) that may disrupt the healthy development of an unborn child. If participants are currently taking any medications that thin their blood, participants will not be eligible for this study. Participants will have to meet other criteria to be eligible, which will be reviewed with participants upon their consent. The investigators will screen up to 15 people and expect that up to 10 individuals will complete this study.

02

Conditions studied

  • Phantom Limb

Keywords

  • Phantom Limb
  • Upper Amputee
  • Electrodes
  • Implant
  • Pain
03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • have an upper-limb amputation
  • must be between the ages of 18 and 70
  • be at least one year post-amputation
  • be willing to travel to the University of Pittsburgh at least twice per week for 29 days

Exclusion criteria

Exclusion Criteria:

  • women who are pregnant or plan to become pregnant during the study
  • all participants cannot have any serious diseases or disorders that affect your ability to participate in this study
  • must not be currently taking any medications that thin your blood
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
4 participants (actual)

Study arms

  • Experimental
    Boston Scientific cord stimulator lead

    A Boston Scientific Stimulator Lead (PMA P030017) will be placed in the cervical epidural space of ten upper-limb amputees and steered laterally towards the dorsal spinal roots under fluoroscopic guidance.

    Device: Boston Scientific Stimulator Lead

Interventions

  • DeviceBoston Scientific Stimulator Lead

    A Boston Scientific (PMA P030017) spinal cord stimulator lead will be placed in the cervical epidural space of ten upper-limb amputees and steered laterally towards the dorsal spinal roots under fluoroscopic guidance.

05

What researchers measure

Primary outcomes

  1. Stimulation Thresholds to a Variety of Stimulus Parameters

    Quantify the threshold (minimum charge) stimulus required to evoke sensation and neurophysiological responses during epidural spinal nerve stimulation, and monitor changes in those percepts and responses over time.

    Time frame: 30 days

  2. Week 1 Average Stimulus Charge for All Subjects

    The average stimulus (nC) required to evoke sensation during week 1 of implant duration.

    Time frame: first 7 days of implant

  3. Week 2 Average Stimulus Charge for All Subjects

    The average stimulus (nC) required to evoke sensation during week 2 of implant duration.

    Time frame: During days 7-14 of implant

  4. Week 3 Average Stimulus Charge for All Subjects

    The average stimulus (nC) required to evoke sensation during week 3 of implant duration.

    Time frame: During days 15 to 21 of implant

  5. Week 4 Average Stimulus Charge for All Subjects

    The average stimulus (nC) required to evoke sensation during week 4 of implant duration.

    Time frame: During days 22-28 of implant

Secondary outcomes

  1. Number of Participants Who Were Able to Discern Specific Regions of the Spinal Cord That Evoked Sensations

    Evaluate the relationship between stimulation parameters and the modality and naturalness of perceived sensations.

    Time frame: 30 days

  2. Qualitative Self-report of Evoked Sensations

    Document the subjective perception of cervical epidural spinal nerve stimulation for restoration of sensation. The investigators will ask each subject to provide subjective feedback on their perceived utility of the sensory feedback provided by the device.

    Time frame: 30 days

  3. Change in Pain Ratings After Study Completion

    Participants were asked to complete the McGill pain questionnaire at baseline, and weekly throughout implant. We expected to see a decrease in the pain level due to electrical stimulation. A positive score indicates a decrease in level of pain (baseline - study end). Minimum score is 0. Maximum score is 80. The higher the number, the greater the pain. This outcome measure suntracts the baseline pain score from the final pain score. A positive score indicates a reduction in pain from baseline.

    Time frame: 30 days

  4. Success Rate During Control of Prosthetic Hand to Identify Object Size

    Investigators will test the subject's ability to use a myoelectric prosthetic hand with and without sensory feedback provided by electrical stimulation of the spinal roots. Using either a virtual prosthetic limb or an instrumented prosthesis, stimulation of the spinal roots will be modulated based on signals recorded from the limb such as pressure at the finger tips or joint angles. In both the presence and absence of stimulation, subjects will be asked to perform tasks such as manipulating blocks, opening a jar, or identifying the stiffness and size of various objects.

    Time frame: 30 days

  5. Success Rate During Control of Prosthetic Hand to Identify Object Compliance (Soft, Medium, Hard)

    Investigators tested the subject's ability to use a myoelectric prosthetic hand with and without sensory feedback provided by electrical stimulation of the spinal roots. Using either a virtual prosthetic limb or an instrumented prosthesis, stimulation of the spinal roots was modulated based on signals recorded from the limb such as pressure at the finger tips or joint angles. In both the presence and absence of stimulation, subjects were asked to perform tasks such as manipulating blocks, opening a jar, or identifying the stiffness (soft, medium, hard) and size of various objects.

    Time frame: 30 days

06

Results

Posted Oct 8, 2025

Participant flow

Participants were met in amputee clinics, referred by prosthetics representatives, or responded to advertisements posted at amputee support groups. The study team spoke with approximately 25 interested patients. Of these, four completed the consent process.

Participant flow — Overall Study
MilestoneBoston Scientific Cord Stimulator Lead
Started4
Completed4
Not completed0

Outcome measures

PrimaryStimulation Thresholds to a Variety of Stimulus Parameters

Quantify the threshold (minimum charge) stimulus required to evoke sensation and neurophysiological responses during epidural spinal nerve stimulation, and monitor changes in those percepts and responses over time.

Time frame:
30 days
Reported as:
Mean · milliamps
Stimulation Thresholds to a Variety of Stimulus Parameters
milliampsBoston Scientific Cord Stimulator Lead
Stimulation Thresholds to a Variety of Stimulus Parameters2.13 (1.25 to 3.75)
PrimaryWeek 1 Average Stimulus Charge for All Subjects

The average stimulus (nC) required to evoke sensation during week 1 of implant duration.

Time frame:
first 7 days of implant
Reported as:
Mean · nC
Week 1 Average Stimulus Charge for All Subjects
nCBoston Scientific Cord Stimulator Lead
Week 1 Average Stimulus Charge for All Subjects647 (174 to 4000)
PrimaryWeek 2 Average Stimulus Charge for All Subjects

The average stimulus (nC) required to evoke sensation during week 2 of implant duration.

Time frame:
During days 7-14 of implant
Reported as:
Mean · nC
Week 2 Average Stimulus Charge for All Subjects
nCBoston Scientific Cord Stimulator Lead
Week 2 Average Stimulus Charge for All Subjects807 (300 to 4384)
PrimaryWeek 3 Average Stimulus Charge for All Subjects

The average stimulus (nC) required to evoke sensation during week 3 of implant duration.

Time frame:
During days 15 to 21 of implant
Reported as:
Mean · nC
Week 3 Average Stimulus Charge for All Subjects
nCBoston Scientific Cord Stimulator Lead
Week 3 Average Stimulus Charge for All Subjects1115 (500 to 4800)
PrimaryWeek 4 Average Stimulus Charge for All Subjects

The average stimulus (nC) required to evoke sensation during week 4 of implant duration.

Time frame:
During days 22-28 of implant
Reported as:
Mean · nC
Week 4 Average Stimulus Charge for All Subjects
nCBoston Scientific Cord Stimulator Lead
Week 4 Average Stimulus Charge for All Subjects902 (300 to 3775)
SecondaryNumber of Participants Who Were Able to Discern Specific Regions of the Spinal Cord That Evoked Sensations

Evaluate the relationship between stimulation parameters and the modality and naturalness of perceived sensations.

Time frame:
30 days
Reported as:
Count of participants · Participants
Number of Participants Who Were Able to Discern Specific Regions of the Spinal Cord That Evoked Sensations
ParticipantsBoston Scientific Cord Stimulator Lead
Felt stimulation4
Felt stim in hand4
Felt stim in elbow3
Felt stim in shoulder2
Felt stim in fingers4
C6 evoked stim3
C7 evoked stim3
C8 evoked stim4
T1 evoked stim4
T2 evoked stim2
SecondaryQualitative Self-report of Evoked Sensations

Document the subjective perception of cervical epidural spinal nerve stimulation for restoration of sensation. The investigators will ask each subject to provide subjective feedback on their perceived utility of the sensory feedback provided by the device.

Time frame:
30 days
Reported as:
Count of participants · Participants
Qualitative Self-report of Evoked Sensations
ParticipantsBoston Scientific Cord Stimulator Lead
Paresthetic sensation (primarily)1
Mixed Modality (paresthetic and naturalistic)2
Naturalistic (primarily)1
SecondaryChange in Pain Ratings After Study Completion

Participants were asked to complete the McGill pain questionnaire at baseline, and weekly throughout implant. We expected to see a decrease in the pain level due to electrical stimulation. A positive score indicates a decrease in level of pain (baseline - study end). Minimum score is 0. Maximum score is 80. The higher the number, the greater the pain. This outcome measure suntracts the baseline pain score from the final pain score. A positive score indicates a reduction in pain from baseline.

Time frame:
30 days
Reported as:
Mean · score on a scale
Change in Pain Ratings After Study Completion
score on a scaleBoston Scientific Cord Stimulator Lead
Change in Pain Score (baseline - final)14.3 (6 to 20)
Baseline Pain Score32.3 (29 to 35)
Final Pain Score18 (12 to 29)
SecondarySuccess Rate During Control of Prosthetic Hand to Identify Object Size

Investigators will test the subject's ability to use a myoelectric prosthetic hand with and without sensory feedback provided by electrical stimulation of the spinal roots. Using either a virtual prosthetic limb or an instrumented prosthesis, stimulation of the spinal roots will be modulated based on signals recorded from the limb such as pressure at the finger tips or joint angles. In both the presence and absence of stimulation, subjects will be asked to perform tasks such as manipulating blocks, opening a jar, or identifying the stiffness and size of various objects.

Time frame:
30 days
Reported as:
Number · percentage of success identifying size
Success Rate During Control of Prosthetic Hand to Identify Object Size
percentage of success identifying sizeSize Discrimination Using Virtual DEKA Arm
Success Rate During Control of Prosthetic Hand to Identify Object Size74
SecondarySuccess Rate During Control of Prosthetic Hand to Identify Object Compliance (Soft, Medium, Hard)

Investigators tested the subject's ability to use a myoelectric prosthetic hand with and without sensory feedback provided by electrical stimulation of the spinal roots. Using either a virtual prosthetic limb or an instrumented prosthesis, stimulation of the spinal roots was modulated based on signals recorded from the limb such as pressure at the finger tips or joint angles. In both the presence and absence of stimulation, subjects were asked to perform tasks such as manipulating blocks, opening a jar, or identifying the stiffness (soft, medium, hard) and size of various objects.

Time frame:
30 days
Reported as:
Number · percentage of success identifying compli
Success Rate During Control of Prosthetic Hand to Identify Object Compliance (Soft, Medium, Hard)
percentage of success identifying compliCompliance Discrimination Using DEKA Arm
Success Rate During Control of Prosthetic Hand to Identify Object Compliance (Soft, Medium, Hard)60

Adverse events

Collected over 30 days (duration of implant). Non-serious events are listed at a 1% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Boston Scientific Cord Stimulator Lead0/4 (0%)0/4 (0%)2/4 (50%)
Most frequent other events
Most frequent other events
EventBoston Scientific Cord Stimulator Lead
Lead migrationSurgical and medical procedures2/4

Baseline characteristics

The first participant experienced lead migration and early explant. This participant was later re-enrolled and completed study activities. Therefore, there are 4 unique individuals counted among the 5 consented participants.

Age, Categorical
Age, Categorical(Participants)Boston Scientific Cord Stimulator Lead
<=18 years0
Between 18 and 65 years3
>=65 years1
Sex: Female, Male
Sex: Female, Male(Participants)Boston Scientific Cord Stimulator Lead
Female3
Male1
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Boston Scientific Cord Stimulator Lead
Hispanic or Latino0
Not Hispanic or Latino4
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Boston Scientific Cord Stimulator Lead
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American1
White3
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Boston Scientific Cord Stimulator Lead
United States4
Participants with phantom limb pain
Participants with phantom limb pain(Participants)Boston Scientific Cord Stimulator Lead
Count of participants3
07

Study locations

1 site
  • University of Pittsburgh
    Pittsburgh, Pennsylvania 15213, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Jan 8, 2025

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — Study sponsors will have access to research data and documents in order to monitor the integrity of the study.

Supporting information: Study protocol, Sap, Icf

09

Registry details

Key details

Study ID
NCT02684201
Lead sponsor
Lee Fisher, PhD
Responsible party
Lee Fisher, PhD (PhD, Assistant Professor, University of Pittsburgh) — Sponsor-investigator
First posted
Feb 17, 2016
Start date
Nov 1, 2015
Primary completion
Aug 1, 2024
Completion
Aug 1, 2024
Results posted
Oct 8, 2025
Last update
Oct 8, 2025

Study contacts

Lee E Fisher, PhD
principal investigator · University of Pittsburgh

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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