An interventional study of Anodal cerebellar and cathodal spinal tDCS and Sham cerebellar and sham spinal tDCS in Ataxia, Cerebellar, Cerebellar Ataxia and Spinocerebellar Ataxias, sponsored by Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia. Completed at 1 site in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-03-03.
Sponsored by Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia · Not applicable, Interventional, and Treatment
Neurodegenerative cerebellar ataxias represent a group of disabling disorders for which we currently lack effective therapies. Cerebellar transcranial direct current stimulation (tDCS) is a non-invasive technique, which has been demonstrated to modulate cerebellar excitability and improve symptoms in patients with cerebellar ataxias. In this randomized, double-blind, sham-controlled study, the investigators will evaluate whether a two-weeks' treatment with cerebellar anodal tDCS and spinal cathodal tDCS can improve symptoms in patients with neurodegenerative cerebellar ataxia and can modulate cerebello-motor connectivity, at short and long term.
Neurodegenerative cerebellar ataxias represent a heterogeneous group of disabling disorders in which progressive ataxia of gait, limb dysmetria, oculomotor deficits, dysarthria and kinetic tremor are the prominent clinical manifestations. Both the hereditary and sporadic forms usually present in young adulthood, and are characterized by atrophy of cerebellar or brainstem structures. Currently, cerebellar ataxia lack effective disease-modifying therapies.
Cerebellar transcranial direct current stimulation (tDCS) is a non-invasive technique, which has been demonstrated to modulate cerebellar excitability and improve symptoms in patients with cerebellar ataxias. The present randomized, double-blind, sham-controlled study will investigate whether a two-weeks' treatment with cerebellar anodal tDCS and spinal cathodal tDCS can improve symptoms in patients with neurodegenerative cerebellar ataxia and can modulate cerebello-motor connectivity, at short and long term.
Subjects will be randomized in two groups, one receiving a 10 day (5 days/week for 2 weeks) treatment with anodal cerebellar and cathodal spinal tDCS and the other receiving sham stimulation with identical parameters. After the intervention, patients will be reassessed with a clinical and neurophysiological evaluation at 2 weeks, 1 months and 3 month after treatment.
33 studies on the registry are indexed under Machado-Joseph Disease; 5 are open to participants now.
This study's enrollment of 21 is close to the median of 23 across 21 interventional studies indexed under Machado-Joseph Disease.
Browse Machado-Joseph Disease studies →Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia is the lead sponsor of 84 studies on the registry; 15 are open to participants now.
Compared within Machado-Joseph Disease, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Cerebellar Ataxia. The counts are of registry records indexed under each term, refreshed daily. How we classify →
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Exclusion Criteria:
10 days anodal cerebellar and cathodal spinal tDCS
Device: Anodal cerebellar and cathodal spinal tDCS
10 days sham cerebellar and sham spinal tDCS
Device: Sham cerebellar and sham spinal tDCS
10 sessions of anodal cerebellar and cathodal spinal transcranial direct current stimulation (5 days/week for 2 weeks)
10 sessions of sham cerebellar and sham spinal transcranial direct current stimulation (5 days/week for 2 weeks)
Change in the International Cooperative Ataxia Rating Scale (ICARS) Score From Baseline
International Cooperative Ataxia Rating Scale (ICARS): semi-quantitative 100-point scale, yielding a total score of 0 (no ataxia) to 100 (most severe ataxia).
Time frame: Baseline - 2 weeks
Change in the Scale for the Assessment and Rating of Ataxia (SARA) Score From Baseline
Scale for the Assessment and Rating of Ataxia (SARA): 8-item performance based scale, yielding a total score of 0 (no ataxia) to 40 (most severe ataxia).
Time frame: Baseline - 2 weeks
Change in the International Cooperative Ataxia Rating Scale (ICARS) Score From Baseline
International Cooperative Ataxia Rating Scale (ICARS): semi-quantitative 100-point scale, yielding a total score of 0 (no ataxia) to 100 (most severe ataxia).
Time frame: Baseline - 2 weeks - 1 month - 3 months
Change in the Scale for the Assessment and Rating of Ataxia (SARA) Score From Baseline
Scale for the Assessment and Rating of Ataxia (SARA): 8-item performance based scale, yielding a total score of 0 (no ataxia) to 40 (most severe ataxia).
Time frame: Baseline - 2 weeks - 1 month - 3 months
Change in the 9 Hole Peg Test (9HPT) Score From Baseline
4 timed trials of the 9 hole peg test (9HPT) were performed and averaged (mean values are reported) for each separate hand (dominant and nondominant). The total time to complete the task is recorded for each trial and for each separate hand (dominant and nondominant). Longer times represent greater impairment.
Time frame: Baseline - 2 weeks - 1 month - 3 months
Change in the 8-Meter Walking Time (8MW) Score From Baseline
4 timed trials of the 8 meter walking time (8MW) were performed and averaged (mean values are reported). Longer times represent greater impairment.
Time frame: Baseline - 2 weeks - 1 month - 3 months
Change in Cerebellar Brain Inhibition (CBI) Measurements From Baseline
Cerebellar brain inhibition (CBI) is expressed as motor evoked potential amplitude (average of 10 recordings). Lower values reflect higher inhibition and thus reduced impairment.
Time frame: Baseline - 2 weeks - 1 month - 3 months
Change in the Short-Form Health Survey 36 (SF36) Score From Baseline
The Italian version of the Short-Form Health Survey 36 (SF-36): consists of 36 scaled score, yielding a total score of 0 (more disability) to 100 (less disability).
Time frame: Baseline - 2 weeks - 1 month - 3 months
| Milestone | Real tDCS, Then Sham tDCS | Sham tDCS, Then Real tDCS |
|---|---|---|
| Started | 10 | 11 |
| Received intervention | 10 | 11 |
| Completed | 10 | 10 |
| Not completed | 0 | 1 |
| Withdrew: Withdrawal by subject | 0 | 1 |
| Milestone | Real tDCS, Then Sham tDCS | Sham tDCS, Then Real tDCS |
|---|---|---|
| Started | 10 | 10 |
| Completed | 10 | 10 |
| Not completed | 0 | 0 |
| Milestone | Real tDCS, Then Sham tDCS | Sham tDCS, Then Real tDCS |
|---|---|---|
| Started | 10 | 10 |
| Completed | 10 | 10 |
| Not completed | 0 | 0 |
International Cooperative Ataxia Rating Scale (ICARS): semi-quantitative 100-point scale, yielding a total score of 0 (no ataxia) to 100 (most severe ataxia).
| units on a scale | Real tDCS | Sham tDCS |
|---|---|---|
| Baseline | 53.0 ± 18.6 | 52.7 ± 19.4 |
| 2 Weeks | 43.0 ± 19.6 | 52.1 ± 19.7 |
Scale for the Assessment and Rating of Ataxia (SARA): 8-item performance based scale, yielding a total score of 0 (no ataxia) to 40 (most severe ataxia).
| units on a scale | Real tDCS | Sham tDCS |
|---|---|---|
| Change in the Scale for the Assessment and Rating of Ataxia (SARA) Score From Baseline | 15.8 ± 7.6 | 19.7 ± 7.5 |
International Cooperative Ataxia Rating Scale (ICARS): semi-quantitative 100-point scale, yielding a total score of 0 (no ataxia) to 100 (most severe ataxia).
| units on a scale | Real tDCS | Sham tDCS |
|---|---|---|
| Baseline | 53.0 ± 18.6 | 52.7 ± 19.4 |
| 2 Weeks | 43.0 ± 19.6 | 52.1 ± 19.7 |
| 1 Month | 41.3 ± 19.6 | 52.5 ± 19.2 |
| 3 Months | 44.2 ± 19.6 | 52.4 ± 19.4 |
Scale for the Assessment and Rating of Ataxia (SARA): 8-item performance based scale, yielding a total score of 0 (no ataxia) to 40 (most severe ataxia).
| units on a scale | Real tDCS | Sham tDCS |
|---|---|---|
| Baseline | 20.2 ± 7.3 | 19.9 ± 7.3 |
| 2 Weeks | 15.8 ± 7.6 | 19.7 ± 7.5 |
| 1 Month | 15.1 ± 7.7 | 19.7 ± 7.3 |
| 3 Months | 16.1 ± 7.9 | 19.9 ± 7.6 |
4 timed trials of the 9 hole peg test (9HPT) were performed and averaged (mean values are reported) for each separate hand (dominant and nondominant). The total time to complete the task is recorded for each trial and for each separate hand (dominant and nondominant). Longer times represent greater impairment.
| seconds | Real tDCS | Sham tDCS |
|---|---|---|
| Baseline | 53.0 ± 24.3 | 52.2 ± 25.9 |
| 2 Weeks | 46.2 ± 21.3 | 53.4 ± 23.8 |
| 1 Month | 47.1 ± 21.9 | 55.8 ± 28.1 |
| 3 Months | 49.5 ± 20.5 | 54.2 ± 26.2 |
4 timed trials of the 8 meter walking time (8MW) were performed and averaged (mean values are reported). Longer times represent greater impairment.
| seconds | Real tDCS | Sham tDCS |
|---|---|---|
| Baseline | 9.4 ± 3.4 | 9.3 ± 3.3 |
| 2 Weeks | 8.0 ± 2.7 | 9.0 ± 3.9 |
| 1 Month | 7.8 ± 2.7 | 9.9 ± 5.0 |
| 3 Months | 8.4 ± 2.8 | 9.7 ± 4.1 |
Cerebellar brain inhibition (CBI) is expressed as motor evoked potential amplitude (average of 10 recordings). Lower values reflect higher inhibition and thus reduced impairment.
| millivolts | Real tDCS | Sham tDCS |
|---|---|---|
| Baseline | 0.94 ± 0.12 | 0.88 ± 0.12 |
| 2 Weeks | 0.54 ± 0.13 | 0.91 ± 0.12 |
| 1 Month | 0.65 ± 0.14 | 0.95 ± 0.13 |
| 3 Months | 0.74 ± 0.11 | 0.90 ± 0.12 |
The Italian version of the Short-Form Health Survey 36 (SF-36): consists of 36 scaled score, yielding a total score of 0 (more disability) to 100 (less disability).
| units on a scale | Real tDCS | Sham tDCS |
|---|---|---|
| Baseline | 54.7 ± 17.5 | 55.3 ± 19.5 |
| 2 Weeks | 66.5 ± 17.5 | 57.9 ± 18.5 |
| 1 Month | 66.7 ± 16.8 | 60.1 ± 17.8 |
| 3 Months | 61.1 ± 18.8 | 56.3 ± 18.8 |
Collected over 9 months. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Real tDCS, Then Sham tDCS | 0/10 (0%) | 0/10 (0%) | 0/10 (0%) |
| Sham tDCS, Then Real tDCS | 0/11 (0%) | 0/11 (0%) | 0/11 (0%) |
Baseline analysis are reported for 20 participants who completed the first intervention
| Age, Continuous(years) | All Study Participants |
|---|---|
| Mean | 54.6 ± 14.5 |
| Sex: Female, Male(Participants) | All Study Participants |
|---|---|
| Female | 10 |
| Male | 10 |
| Race (NIH/OMB)(Participants) | All Study Participants |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 0 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 0 |
| White | 20 |
| More than one race | 0 |
| Unknown or Not Reported | 0 |
| Region of Enrollment(participants) | All Study Participants |
|---|---|
| Italy | 20 |
| Scale for the Assessment and Rating of Ataxia (SARA) score(units on a scale) | All Study Participants |
|---|---|
| Mean | 20.2 ± 7.4 |
| International Cooperative Ataxia Rating Scale (ICARS) score(units on a scale) | All Study Participants |
|---|---|
| Mean | 53.0 ± 18.6 |
| 9 Hole Peg Test (Dominant hand)(seconds) | All Study Participants |
|---|---|
| Mean | 53.0 ± 24.3 |
| 9 Hole Peg Test (non-Dominant hand)(seconds) | All Study Participants |
|---|---|
| Mean | 56.1 ± 21.5 |
3 further baseline measures are reported on the registry.
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: No
Ran from Feb 2017 to primary completion in Dec 2018, 21 months.
Results were first posted in Jun 2019, 6 months after primary completion.
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Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia