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RecruitingNCT07433023Updated Nov 5, 2026

tSCS and 5-Azacitidine for Enhanced Motor Outcomes in Cerebral Palsy

A Phase 2 interventional study of tSCS and 5-Azacitidine in Cerebral Palsy, sponsored by Shirley Ryan AbilityLab. Recruiting at 1 site in United States. Open to participants aged 4 Years to 17 Years. Per ClinicalTrials.gov, last updated 2026-11-05.

Sponsored by Shirley Ryan AbilityLab · Phase 2, Interventional, and Other

From the registry’s dates

  • Started May 2026; still recruiting 5 months later.
Updated Nov 5, 2026Primary completion movedStudy completion moved+2 moreGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
4 Years to 17 Years
Sex
All
01

Study summary

This is an intervention study to investigate the impact of spinal stimulation on mobility outcomes in children with Cerebral Palsy. Participants will complete a 16-week training program with weekly sessions of spinal stimulation and walking or activity-based training. Participants will also have the option to participate in a randomized control trial to investigate the impact of 5-Azacitidine combined with the spinal stimulation to further affect mobility outcomes.

Read the detailed description

This project will investigate the impact of transcutaneous spinal cord stimulation (tSCS) on gait and activity-based training in children with Cerebral Palsy. Through a 1:1 randomization, a subset of participants will also receive a dose of 5-azacitidine (AZA), an FDA-approved drug for pediatric oncology, or a placebo. Research in muscle fibers as shown that AZA aids in muscle growth and regeneration. The use of AZA in this study is an off-label application, employed together with the tSCS intervention to investigate the impact of targeting both muscular and mechanical deficits related to CP. This project will also collect blood samples of participants to perform genetic and epigenetic profiling in order to test for correlation with the severity and trajectory of musculoskeletal impairments and with responses to the tSCS and AZA interventions.

The study team hypothesizes that personalized tSCS combined with targeted gait or activity based training will improve motor outcomes in children with spastic CP by reducing muscle tone, improving gait symmetry and neuromotor function, and increasing functional mobility. Furthermore, the addition of a repurposed anabolic agent (AZA) will augment these gains compared to tSCS and training alone.

Children with CP across GMFCS levels will participate in a three-phase protocol, including: (1) a two week baseline phase, (2) a sixteen week intervention phase during which participants will receive tSCS and training interventions, and (3) a four-week post-intervention phase to examine long term outcomes. At the midpoint, participants will receive a single dose of AZA or a single dose of a placebo through a 1:1 randomization. Participants will have a blood draw in phase 1 for genetic and pre-intervention epigenetic profiling and will have a second blood draw in phase 3 for post-intervention epigenetic profiling.

02

Conditions studied

  • Cerebral Palsy

Browse trials for

Keywords

  • Pediatric
  • Transcutaneous Spinal Stimulation
03

In context

Cerebral Palsy

1,936 studies on the registry are indexed under Cerebral Palsy; 458 are open to participants now.

This study's planned enrollment of 80 is above the median of 34 across 1,431 interventional studies indexed under Cerebral Palsy.

Browse Cerebral Palsy studies →

Lead sponsor

Shirley Ryan AbilityLab is the lead sponsor of 180 studies on the registry; 44 are open to participants now.

Of its 10 completed or terminated interventional studies of FDA-regulated products, 4 (40%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

The criteria were revised on the registry on Nov 5, 2026. See what changed

Ages eligible
4 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Diagnosis of cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) Levels I-V.
  • Between 4 and 17 years old at the time of enrollment/consent.
  • Diagnosis of spastic CP hemiplegia, diplegia, or quadriplegia.
  • Stable medical condition as determined by the investigator.
  • Adequate caregiver support to be able to participate in training and assessment sessions for the duration of the study, at the discretion of the Investigator.
  • Capable of performing simple cued motor tasks and can follow 2-3 step commands.
  • Capable of communicating an accurate yes or no answer to questions according to parent or guardian.
  • Able to localize pain/ discomfort.
  • Physician approval for participation.
  • Parent/ guardian permission.

Exclusion criteria

Exclusion Criteria:

  • Concurrent neurological disease affecting the central nervous system.
  • Cardiovascular or musculoskeletal disease or injury that would prevent full participation in physical therapy intervention
  • Orthopedic dysfunction, injury, or surgery that would impact an individual's ability to use the upper and/or lower extremity
  • Unhealed fracture or other musculoskeletal impairment that might interfere with upper or lower extremity rehabilitation or testing activities
  • Implanted stimulator (e.g., epidural stimulator, vagus nerve stimulator, pacemaker, cochlear implant) or drug delivery device (e.g., baclofen pump)
  • Dependence on an electro-magnetic medical implant (e.g., cardiac pacemaker, implanted drug pump), ventilation support, or another external device.
  • History of uncontrolled seizures
  • Unexplained presence of persistent complaints of pain of any kind
  • Unable to localize pain/discomfort
  • Severe cortico-visual impairment
  • Active pressure sores
  • Active cancer or cancer in remission less than 5 years
  • depression, psychiatric disorders, or ongoing drug abuse
  • Immunodeficiency or hematologic condition
  • Allergy to AZA or mannitol
  • Plans to receive a vaccine within 30 days of the planned AZA or placebo injection to take place at week 10
  • Pregnancy
  • Orthopedic surgery completed in the prior 12 months
  • Intrathecal medication titration that may affect muscle spasticity
  • Botulinum toxin treatment within 3 months preceding enrollment unless given approval by the treating physician
  • Current enrollment in a conflicting research study
  • Any other health condition or diagnosis not listed above that may put the participant at risk as determined by the investigator or treating physician
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Phase 2
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
80 participants (estimated)

Study arms

  • Active comparator
    tSCS + Functional Activity Training

    Transcutaneous spinal cord stimulation will be paired with training based on Aim. Participants in Aim 1(GMFCS levels 1-3) will engage in three sessions a week for 16 weeks of treadmill and overground gait training using tSCS. Participants in Aim 2(GMFCS levels 4-5) will engage in three sessions a week for 16 weeks of functional activity based training as appropriate.

    Other: tSCS · Other: Functional Activity Training

  • Experimental
    tSCS + Functional Activity Training + 5-Azacitidine

    Transcutaneous spinal cord stimulation will be paired with training based on Aim. Participants in Aim 1(GMFCS levels 1-3) will engage in three sessions a week for 16 weeks of treadmill and overground gait training using tSCS. Participants in Aim 2(GMFCS levels 4-5) will engage in three sessions a week for 16 weeks of functional activity based training as appropriate. A subset of opt-in participants will also be randomized to receive either 5-Azacitidine (VIDAZA) or placebo (Mannitol) at midpoint. A registered nurse will deliver a single subcutaneous injection of either AZA or placebo at a dose of 75 mg/m² to the participants lower abdomen or medial thigh.

    Other: tSCS · Drug: 5-Azacitidine · Other: Functional Activity Training

  • Active comparator
    tSCS + Functional Activity Training + Mannitol (Placebo)

    Transcutaneous spinal cord stimulation will be paired with training based on Aim. Participants in Aim 1(GMFCS levels 1-3) will engage in three sessions a week for 16 weeks of treadmill and overground gait training using tSCS. Participants in Aim 2(GMFCS levels 4-5) will engage in three sessions a week for 16 weeks of functional activity based training as appropriate. A subset of opt-in participants will also be randomized to receive either 5-Azacitidine (VIDAZA) or placebo (Mannitol) at midpoint. A registered nurse will deliver a single subcutaneous injection of either AZA or placebo at a dose of 75 mg/m² to the participants lower abdomen or medial thigh.

    Other: tSCS · Drug: Mannitol · Other: Functional Activity Training

Interventions

  • OthertSCS

    Participants will participate in three 45 minute sessions per week for a total of 16 weeks involving transcutaneous spinal stimulation and activity based training. Stimulation intensity will be based on involuntary motor threshold, determined during a MEPs assessment.

    Also known as: Transcutaneous Spinal Stimulation

  • A subset of opt-in participants will receive a single subcutaneous injection of 5-Azacitidine at a dose of 75 mg/m²

    Also known as: VIDAZA

  • A subset of opt-in participants will receive a single subcutaneous injection of Mannitol (placebo) at a dose of 75 mg/m².

    Also known as: Placebo

  • OtherFunctional Activity Training

    All participants will engage in functional activity training based on Aim. Participants will participate in three 45 minute sessions per week for a total of 16 weeks involving transcutaneous spinal stimulation (tSCS) and activity based training. Participants in Aim 1 will complete gait training. Participants in Aim 2 will complete activity-based training.

06

What researchers measure

Primary outcomes

  1. Spatiotemporal Gait Symmetry via Instrumented Gait-Mat

    For Aim 1 participants (GMFCS levels 1-3), an instrumented gait-mat will be used to assess spatiotemporal gait symmetry.

    Time frame: Baseline to Follow-Up, approximately 22 weeks

  2. Modified Tardieu Scale

    For Aim 2 participants (GMFCS levels 4-5), muscle spasticity will be assessed using the Modified Tardieu Scale.

    Time frame: Baseline to Follow-Up, approximately 22 weeks

07

Study locations

1 of 1 sites recruiting
08

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it moved

Started May 2026 (actual). Primary completion is estimated for Aug 2030, 51 months after the start.

Since we started tracking on Sep 25, 2026, the dates moved once, on Nov 5, 2026: primary completion Jan 2029 → Aug 2030 and completion Jan 2029 → Aug 2030.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Feb 5, 2026
First posted
Feb 25, 2026
StartActual
May 28, 2026
Primary completionEst.
Aug 31, 2030was Jan 2029
CompletionEst.
Aug 31, 2030was Jan 2029
Last update
Nov 5, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Primary completion
Jan 1, 2029→Aug 31, 2030
Nov 5, 2026
Study completion
Jan 1, 2029→Aug 31, 2030
Nov 5, 2026
Eligibility
1 exclusion criterion removed
What changed in the criteria
Exclusion criteria
  • RemovedActive urinary tract infection
Nov 5, 2026
Contact
Study contact changed: j•••@sralab.org · •••7620→t•••@sralab.org · •••0718. See the current contact
Nov 5, 2026
Show all 1 update
  1. Nov 5, 2026
    Primary completion Jan 1, 2029→Aug 31, 2030
    Study completion Jan 1, 2029→Aug 31, 2030
    Eligibility 1 exclusion criterion removed
    What changed in the criteria
    Exclusion criteria
    • RemovedActive urinary tract infection
    Contact Study contact changed: j•••@sralab.org · •••7620→t•••@sralab.org · •••0718. See the current contact
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT07433023
Responsible party
Arun Jayaraman, PT, PhD (Scientific Chair, Technology & Innovation, Shirley Ryan AbilityLab) — Principal investigator
First posted
Feb 25, 2026
Start date
May 28, 2026
Primary completion
Aug 31, 2030 (estimated)
Completion
Aug 31, 2030 (estimated)
Last update
Nov 5, 2026

Study contacts

Audrey Wiesner, BS
Contact
awiesner@sralab.org
3122388435
Tyler Petrie, PhD
Contact
tpetrie@sralab.org
3122380718
Arun Jayaraman, PhD
principal investigator · Shirley Ryan AbilityLab

Oversight

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

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