CClinicalTrials.gg
CompletedNCT03499314Updated Mar 9, 2022Results posted

A Pilot Trial of Remotely-Supervised Transcranial Direct Current Stimulation (RS-tDCS) to Enhance Motor Learning in Progressive Multiple Sclerosis (MS)

An interventional study of Active RS-tDCS +At-Home Manual Dexterity Training and Sham RS-tDCS +At-Home Manual Dexterity Training in Multiple Sclerosis, sponsored by NYU Langone Health. Completed at 1 site in United States. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2022-03-09.

Sponsored by NYU Langone Health · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
65
Allocation
Randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

This is a randomized, double-blind pilot clinical trial to test a novel treatment approach to rehabilitate fine motor function in individuals living with progressive multiple sclerosis (MS) using anodal transcranial direct current stimulation (tDCS) to augment manual dexterity training. Treatment will be delivered to individuals at home using a state-of-the-art remotely supervised tele-rehabilitation protocol, a major advantage for patients with respect to ease of access, feasibility, reinforcement learning and minimal burden of in clinic study visit participation. Improvements in fine motor skill will be assessed at each remote session using a novel portable grip device that measures execution and adaptation or learning of fingertip forces during grasp, which is more sensitive than standard measures of hand function.

02

Conditions studied

  • Multiple Sclerosis

Keywords

  • Anodal transcranial stimulation (tDCS)
03

Who can participate

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

Inclusion criteria

  • Definite MS diagnosis, progressive subtype
  • 9HPT score between -1.0 and -4.0 standard deviations from age-based normative data
  • Score of \< 7.5 or less on the EDSS (with caregiver proxy required for those with scores of 6.5 or greater)*
  • Ability to understand the informed consent process and provide consent to participate in the study

Exclusion criteria

Exclusion Criteria:

  • Primary neurologic, psychiatric or other medical disorder other than MS
  • Use of upper extremity Botox injection within 3 months
  • Current use of intrathecal Baclofen
  • History of seizure disorder
  • History of head trauma or medical device in head or neck
  • Clinically significant abnormality on EKG
  • Symbol Digit Modalities Test or SDMT score ≥3.0 SD from published norms
  • WRAT-4 reading level below average (\<85) (estimated general intellectual function)
  • Skin disorder/sensitive near stimulation locations
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Care provider)
Enrollment
65 participants (actual)

Study arms

  • Experimental
    RS-tDCS Stimulation

    20 times 20 minute stimulation session supervised by a study technician through a videoconferencing platform, VSee

    Device: Active RS-tDCS +At-Home Manual Dexterity Training · Other: Manual dexterity training

  • Placebo comparator
    Sham Stimulation

    20 ×20-minute sessions sham tDCS

    Device: Sham RS-tDCS +At-Home Manual Dexterity Training · Other: Manual dexterity training

Interventions

  • DeviceActive RS-tDCS +At-Home Manual Dexterity Training

    Bilateral M1-SO electrode placement; Active= anodal 2.0 mA dose × 20 minutes

  • DeviceSham RS-tDCS +At-Home Manual Dexterity Training

    Designed to ensure blinding, includes initial and ending "ramp-up/down" stimulation for 60 seconds

  • OtherManual dexterity training

    Manual dexterity training will be based on the at-home study in MS by Kamm and colleagues, where the training was completed by participants in their homes and demonstrated to be superior to strength training.

05

What researchers measure

Primary outcomes

  1. Mean Preload Phase Duration (PLD)

    (PLD) is the duration of finger contact until the onset of positive load force. It assesses the time taken to stabilize grasp and is a robust measure of grasp execution.

    Time frame: baseline and 30 minutes for each of 20 sessions, values averaged across sessions

06

Results

Posted Mar 9, 2022

Participant flow

Participant flow — Overall Study
MilestoneRS-tDCS StimulationSham Stimulation
Started3332
Completed3129
Not completed23
Withdrew: Time commitment12
Withdrew: Medical issue unrelated to research study11

Outcome measures

PrimaryMean Preload Phase Duration (PLD)

(PLD) is the duration of finger contact until the onset of positive load force. It assesses the time taken to stabilize grasp and is a robust measure of grasp execution.

Time frame:
baseline and 30 minutes for each of 20 sessions, values averaged across sessions
Reported as:
Mean · seconds
Mean Preload Phase Duration (PLD)
secondsRS-tDCS StimulationSham Stimulation
Pre-Stimulation0.152 ± 0.04240.238 ± 0.0481
Post-Stimulation0.163 ± 0.04260.202 ± 0.0476

Adverse events

Collected over 1 month. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
RS-tDCS Stimulation0/33 (0%)0/33 (0%)24/33 (72.7%)
Sham Stimulation0/32 (0%)0/32 (0%)22/32 (68.8%)
Most frequent other events
Most frequent other events
EventRS-tDCS StimulationSham Stimulation
Skin TinglingGeneral disorders17/3320/32
Skin ItchingGeneral disorders16/3310/32
Skin WarmingGeneral disorders16/337/32

Baseline characteristics

Age, Continuous
Age, Continuous(years)RS-tDCS StimulationSham StimulationTotal
Mean55.23 ± 8.5853.72 ± 7.6254.49 ± 8.11
Sex: Female, Male
Sex: Female, Male(Participants)RS-tDCS StimulationSham StimulationTotal
Female222446
Male11819
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)RS-tDCS StimulationSham StimulationTotal
Hispanic or Latino000
Not Hispanic or Latino333265
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)RS-tDCS StimulationSham StimulationTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American347
White282856
More than one race000
Unknown or Not Reported202
Region of Enrollment
Region of Enrollment(participants)RS-tDCS StimulationSham StimulationTotal
United States333265
07

Study locations

1 site
  • New York University School of Medicine
    New York, New York 10016, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Apr 8, 2020

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

09

Registry details

Key details

Study ID
NCT03499314
Lead sponsor
NYU Langone Health
Responsible party
Sponsor
First posted
Apr 17, 2018
Start date
Apr 15, 2018
Primary completion
Nov 30, 2020
Completion
Nov 30, 2020
Results posted
Mar 9, 2022
Last update
Mar 9, 2022

Study contacts

Leigh Charvet, MD
principal investigator · NYU Langone Health

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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