NCT04017481

Brief Summary

Movement disorders are neurological syndromes leading to excessive movements or to limited control of voluntary and automatic movements. Many of these disorders are not life-threatening but represent serious difficulties in carrying out the activities of daily living and reduce patient's independence and quality of life. This project NeuroMOD (neuromodulation for patients with disorders of motor control) proposes the development of a neuromodulation-based platform for the rehabilitation and restoration of motor and cognitive functions of patients suffering from Parkinson's disease (PD). Our project will focus on the application of a novel neurorehabilitation strategy, its functional and clinical validation, and on the evaluation of the impact of the use of the technologies involved in the musculoskeletal and the nervous system as well as user behavior. Parkinson's disease was selected as target pathology since it represents a paradigm of motor disorder diseases. Parkinson's disease affects adults and has a very high prevalence and a very high functional impact. In order to achieve this objective, we have defined the following research areas: Subproject 1. NeuroMOD: development of a neuromodulation platform composed by a TMS system, and an EMG (electromyography) and EEG (electroencephalography) system in combination with a system of virtual reality based on immersive glasses. Subproject 2. NeuroMOD-PD: development of therapies and evaluation of clinical evidence and motor and cognitive impact of NeuroMOD in the rehabilitation of patients suffering from Parkinson's disease impact. Subproject 3. NeuroMOD-Image: development of neuroimaging techniques to investigate the brain areas affected by the proposed therapies and temporary terms that neural plasticity is induced and evolves in Parkinson´s Disease.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
50

participants targeted

Target at P50-P75 for not_applicable parkinson-disease

Timeline
Completed

Started Sep 2016

Typical duration for not_applicable parkinson-disease

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 1, 2016

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 20, 2018

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

July 2, 2019

Completed
10 days until next milestone

First Posted

Study publicly available on registry

July 12, 2019

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 30, 2019

Completed
Last Updated

November 20, 2020

Status Verified

July 1, 2019

Enrollment Period

2.3 years

First QC Date

July 2, 2019

Last Update Submit

November 19, 2020

Conditions

Keywords

neuromodulationTMSNFB

Outcome Measures

Primary Outcomes (4)

  • Motor changes

    UNIFIED PARKINSON'S DISEASE RATING SCALE (UPDRS) part III ( total values from 0-68, higher score worse clinical situation)

    The day before the first stimulation session and 2 weeks after the first stimulation session

  • Motor changes

    UNIFIED PARKINSON'S DISEASE RATING SCALE (UPDRS) part III ( total values from 0-68, higher score worse clinical situation)

    t2(2 weeks after finishing the protocol)

  • Neurophysiological cortical changes

    Cortical silent period measured using transcranial magnetic pulse in M1 and simultaneous register of electromyographical response

    The day before the first stimulation session and 2 weeks after the first stimulation session

  • Neurophysiological cortical changes

    Cortical silent period measured using transcranial magnetic pulse in M1 and simultaneous register of electromyographical response

    t2(2 weeks after finishing the protocol)

Secondary Outcomes (3)

  • Quality of life changes

    t2(2 weeks after finishing the protocol)

  • Encephalographic changes

    t2(2 weeks after finishing the protocol)

  • Cognitive changes in objective measures of processing speed

    t2(2 weeks after finishing the protocol)

Study Arms (4)

Repetitive stimulating transcranial stimulation (rTMS)

EXPERIMENTAL

Subjects receive 8 sessions M1 Neuromodulation using rTMS according to the protocol ( 80% resting motor threshold, 10 Hertz; 1000 pulses; 25 trains de 4 seconds con 25 seconds intertrain.

Other: Repetitive transcranial magnetic stimulation (rTMS)

EEG guided Neurofeedback (NFB)

EXPERIMENTAL

Subjects receive 8 sessions M1 EEG guided NFB with virtual reality goggles in order to modify the beta rhythm. The sessions have a duration of 20min

Other: EEG guided Neurofeedback (NFB)

rTMS + NFB

EXPERIMENTAL

Subjects receive both interventions sequentially

Other: Repetitive transcranial magnetic stimulation (rTMS)Other: EEG guided Neurofeedback (NFB)

No intervention

NO INTERVENTION

No interventions, the patient just comes to be evaluated sequentially according to the timing of experimental groups.

Interventions

The intervention intends to change the cortical plasticity in specific cortical areas. rTMS is a non-invasive exogenous neuromodulation technique that uses repetitive magnetic pulses administered in a specific area of the head in order to influence the connectivity of the underlying brain area.

Repetitive stimulating transcranial stimulation (rTMS)rTMS + NFB

The intervention intends to change the cortical plasticity in specific cortical areas. The NFB is a non-invasive endogenous technique that seeks the self-regulation of cortical activity through the information represented in a videogame which is used to interact with the subject.

EEG guided Neurofeedback (NFB)rTMS + NFB

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Idiopathic Parkinsons Disease
  • Hoehn Yahr Scale I-III
  • No drug changes in the last 90 days

You may not qualify if:

  • Dementia (Minimental scale score \<25)
  • Dependency (modified Rankin scale \> 3)
  • Pregnancy or pregnancy plans
  • Pacemaker
  • Implanted metal devices
  • cochlear implants
  • claustrophobia
  • drug infusion pumps
  • epilepsy / epileptiform anomalies in electroencephalography (EEG)
  • known structural alterations in magnetic resonance imaging (MRI)
  • Atypical Parkinsonism
  • Previous repetitive transcranial magnetic stimulation (rTMS)
  • Severe comorbidity (cancer, severe debilitating diseases, etc.)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (1)

  • Romero JP, Moreno-Verdu M, Arroyo-Ferrer A, Serrano JI, Herreros-Rodriguez J, Garcia-Caldentey J, Rocon de Lima E, Del Castillo MD. Clinical and neurophysiological effects of bilateral repetitive transcranial magnetic stimulation and EEG-guided neurofeedback in Parkinson's disease: a randomized, four-arm controlled trial. J Neuroeng Rehabil. 2024 Aug 5;21(1):135. doi: 10.1186/s12984-024-01427-5.

MeSH Terms

Conditions

Parkinson Disease

Interventions

Transcranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

Parkinsonian DisordersBasal Ganglia DiseasesBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesMovement DisordersSynucleinopathiesNeurodegenerative Diseases

Intervention Hierarchy (Ancestors)

Magnetic Field TherapyTherapeutics

Study Officials

  • Juan Pablo Romero Muñoz, MD PhD

    Universidad Francisco de Vitoria, Facultad de Ciencias Experimentales

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
Final outcomes evaluators are blinded. Clinical evaluation is performed using videotaped neurological examination. Neurophysiological evaluation is done with the raw data recorded during the sessions.
Purpose
TREATMENT
Intervention Model
FACTORIAL
Model Details: Each study participant is assigned to one of the arms. Four intervention groups are defined as rTMS only, NFB only, both TMS and NFB, or neither TMS or NFB
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 2, 2019

First Posted

July 12, 2019

Study Start

September 1, 2016

Primary Completion

December 20, 2018

Study Completion

September 30, 2019

Last Updated

November 20, 2020

Record last verified: 2019-07

Data Sharing

IPD Sharing
Will share

Individual anonymized participant data will be available to other researchers under request.

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
six months after the end of the study
Access Criteria
Individual anonymized participant data will be available to other researchers under request.