N/A
N=44
Noninvasive Neuromodulation for Treatment of Symptoms Due to Mild or Moderate Traumatic Brain Injury
Brain Injuries, Traumatic
Bottom Line
View on ClinicalTrials.gov: NCT02158494 ↗Enrolled (actual)
44
Serious AEs
9.3%
Results posted
May 2019
Primary outcome: Primary: NeuroCom Computerized Dynamic Posturography Sensory Organization Test (SOT) — 42.77; 36.24; 63.73; 62.00 score on a scale — p=0.41
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Balance and Gait Training using neurostimulation modulation. (Device); Sham Device (Device)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- University of Wisconsin, Madison
- Primary completion
- May 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY NeuroCom Computerized Dynamic Posturography Sensory Organization Test (SOT) |
42.77; 36.24; 63.73; 62.00; 70.89; 71.21 | 0.41 |
Summary
The investigators hypothesis is that electrical stimulation to the tongue that directly stimulates two cranial nerve nuclei (Trigeminal and Facial Nerve Nuclei), will excite neural impulses to the brainstem and cerebellum. The investigators call this cranial nerve non-invasive neuromodulation (CN-NINM). The activation of these structures induces neuroplasticity when combined with specific physical, cognitive and/or mental exercises, promoting recovery of selected functional damage such as problems with balance or walking.
44 subjects will be recruited for 2 weeks of intensive In-Lab Balance and Gait Training followed by 12 weeks of intensive Home Training with weekly In-Lab check sessions. Half of the subjects will use CN-NINM in conjunction with the exercise. Half of the subjects will use very low level stimulation in conjunction with the exercise, and will serve as a control group.
Eligibility Criteria
Inclusion Criteria
- All candidates will have a balance disorder as a result of a traumatic brain injury (TBI).
- All candidates will have a NeuroCom® Sensory Organization Test (SOT) composite score at least 8 points below normal after adjustment for age and height [based on normative data].
- All candidates will be between the ages of 18 and 65 (at the time of screening).
- If female of childbearing potential, the candidate agrees to use adequate contraception throughout participation in the study (from enrollment to completion).
- All candidates must have access to a treadmill.
- All candidates will be at least 1 year post-injury.
- All candidates will have a neuroradiologic scan and report after their most recent TBI.
- All candidates will be ambulatory and able to walk for 20 minutes.
- All candidates, if on medications, will not have had any major changes in type or dosage within 3 months of enrollment.
- All candidates will have participated in a focused physical rehabilitation program for their TBI and feel that they have reached a plateau.
- All candidates will be able to understand and willing to give informed consent.
Exclusion Criteria
- All candidates that have oral health problems (e.g. gum disease, active cankers, piercings, oral surgery within the previous 3 months).
- All candidates with non-removable metal orthodontic devices (e.g., braces) or oral cavity piercings that could interfere with PoNS™ use.
- All candidates who have chronic infectious diseases (e.g. hepatitis, HIV, TB).
- All candidates with unmanaged hypertension.
- All candidates with unmanaged diabetes, or complications due to diabetes (e.g. retinopathy, neuropathy, renal disease).
- All candidates with neurological disorders other than those attributed to their primary diagnosis (e.g., MS, PD, ALS, AD or other dementia, uncontrolled pain).
- All candidates with a history of oral cancer.
- All candidates who have been treated for any type of cancer other than basal cell carcinoma within the past year.
- All candidates who have had a penetrating injury, craniotomy (with the exception of a burr hole [trephination] for resolution of acute subdural hematoma), or refractory subdural hematoma.
- Exceptions for other abnormalities identified in neuroradiologic scan reports that are asymptomatic and not expected to change may be made on a case by case basis by the Medical Advisor.
- All candidates with chronic use of psychoactive or psychostimulant medications that, in the opinion of the investigators, would compromise the subject's ability to comprehend and perform the study activities.
- All candidates who have a pacemaker, or are identified as at-risk for cardiovascular events.
- All candidates who are pregnant or lactating.
- All candidates with a lower extremity biomechanical prosthetic.
- All candidates with a history of seizures (except those in the acute or post-acute phases, and are controlled).
- All candidates who who experienced a loss of consciousness greater than 24 hours as a result of their TBI.
- All candidates with a "severe" score in any of the Attention, Memory, or Executive Functions categories on the Cognitive Linguistic Quick Test (CLQT).
- All candidates who, in the opinion of the investigators, are unable to feel the stimulation and successfully complete the device level setting procedure.
Data sourced from ClinicalTrials.gov (NCT02158494). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.