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Wise Young
08-21-2001, 07:37 PM
Physiologic Studies of Spasticity

This study is currently recruiting patients.

Sponsored by

National Institute of Neurological Disorders and Stroke (NINDS)

Purpose

This study will provide information about changes that occur in the motor neurons of the spinal cord (the nerve cells that control the muscles) when the motor cortex (the region of the brain that controls movement) is unable to send messages to the spinal cord and muscles in the normal way. This information will help elucidate how the nervous system adapts after injury or disease of the motor cortex.

Healthy adult volunteers and adults with a spasticity disorder and moderate weakness may be eligible for this study. Patients will be screened with a medical history, physical examination and diagnostic studies as needed. Healthy volunteers will have a neurological examination. Muscle weakness and spasticity will be evaluated in both groups of subjects.

All participants will have electromyography (measurement of electrical activity in muscles) during nerve stimulation and transcranial magnetic stimulation, described below. (Some patients, such as those with a pacemaker or implanted medication pumps, metal objects in the eye, history of epilepsy and others, will not have magnetic stimulation.)

Electromyography < The electrical activity of muscles will be measured either by 1) using metal electrodes taped to the skin overlying a muscle, or 2) using thin wires inserted into the muscle through a needle.

Nerve stimulation < The nerves will be stimulated by applying a small electrical pulse through metal disks on the skin of the arm or leg.

Transcranial magnetic stimulation < A brief electrical current is passed through a wire coil placed on the scalp. This creates a magnetic pulse, which stimulates the brain. During the test, the participant may be asked to tense certain muscles slightly or perform other simple actions.

Nerve block < Some patients will have a nerve block of one of the nerves in the arm. For this procedure, a local anesthetic is injected under the skin to produce numbness and weakness in some arm muscles.

Condition
Muscle Spasticity
Healthy


MEDLINEplusÂ*related topics:Â*Â*MovementÂ*Disorders

Study Type:Â*Natural History


Official Title:Â*Spasticity: Physiologic Studies

Further Study Details:Â*

The purpose of this protocol is to characterize abnormalities in motoneuron recruitment in adult patients with corticospinal tract dysfunction using electrophysiologic measures. We wish to determine whether the intrinsic spinal mechanisms for recruitment are abnormal or whether only inputs to motoneurons are changed. This information is pertinent for assessing ways that can ultimately be used to enhance strength in patients with corticospinal tract dysfunction using the existing spinal circuitry.

Eligibility

Genders Eligible for Study:Â* Both

Criteria

Adult patients with selective corticospinal tract dysfunction.
Moderate severity of weakness (greater than or equal to MRC Grade 4).
Adult normal volunteers only.
No severe weakness with inability to maintain voluntary contractions.
No significant sensory impairment.
For TMS studies only:
No pregnancy, implanted devices such as pacemakers, medication pumps or defibrillators, metal in the cranium except the mouth, intracardiac lines, or history of seizures.


Location and Contact Information

Maryland
National Institute of Neurological Disorders and Stroke (NINDS),Â*9000 Rockville Pike Â* Bethesda, Â* Maryland, Â* 20892, Â* United States;Â*Recruiting

Â*Â* PRPL Â*1-800-411-1222Â* Â* prpl@mail.cc.nih.govÂ*

More Information

Detailed Web Page

Publications

Gemperline. 1995. Characteristics of motor unit discharge in subjects with hemiparesis, Muscle Nerve, Vol. 18, p. 1101

Rosenfalck. 1980. Impaired regulation of force and firing pattern of single motor units in patients with spasticity, J Neurol Neurosurg Psychiatry, Vol. 43, p. 907

Frascarelli. 1998. Initial motor unit recruitment in patients with spastic hemiplegia, Electromyogr Clin Neurophysiol, Vol. 38, p. 267

Study ID NumbersÂ* 01-N-0148
NLM IdentifierÂ* NCT00014976

Date study startedÂ*April 13, 2001
Record last reviewedÂ* March 22, 2001
Last UpdatedÂ* March 22, 2001

Wise Young
04-06-2002, 12:50 PM
New updated link
Clinicaltrial.gov (http://clinicaltrials.gov/ct/gui/c/a1r/show/NCT00014976?order=34&JServSessionIdzone_ct=nh9kvtwwa1)