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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2600125769 |
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最近更新日期: Date of Last Refreshed on: |
2026-05-31 21:39:11 |
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注册时间: Date of Registration: |
2026-05-31 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
基于小脑-脊髓接口促进脑卒中后肢体康复的应用基础研究 |
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Public title: |
Applied basic research on cerebellar–spinal interface–mediated promotion of limb rehabilitation after stroke |
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注册题目简写: |
小脑–脊髓接口卒中康复研究 |
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English Acronym: |
CSI-PSLR Study |
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研究课题的正式科学名称: |
基于小脑-脊髓接口促进脑卒中后肢体康复的应用基础研究 |
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Scientific title: |
An Applied Basic Study of Cerebellar–Spinal Interface-Mediated Limb Rehabilitation After Stroke |
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研究课题代号(代码): Study subject ID: |
CSI-PSLR-001 |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
章昊苏 |
研究负责人: |
刘焕光 |
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Applicant: |
Haosu Zhang |
Study leader: |
Huanguang Liu |
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申请注册联系人电话: Applicant telephone: |
+86 185 0160 0907 |
研究负责人电话: Study leader's telephone: |
+86 159 0129 5380 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
haosu.zhang@gmail.com |
研究负责人电子邮件: Study leader's E-mail: |
hg_liu@163.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
安徽省芜湖市镜湖区赭山西路2号 |
研究负责人通讯地址: |
安徽省芜湖市镜湖区赭山西路2号 |
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Applicant address: |
No. 2, Zheshan West Road, Jinghu District, Wuhu, Anhui Province, China |
Study leader's address: |
No. 2, Zheshan West Road, Jinghu District, Wuhu, Anhui Province, China |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
皖南医科大学第一附属医院(弋矶山医院) |
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Applicant's institution: |
The First Affiliated Hospital of Wannan Medical University (Yijishan Hospital) |
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研究负责人所在单位: |
皖南医科大学第一附属医院(弋矶山医院) |
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Affiliation of the Leader: |
The First Affiliated Hospital of Wannan Medical University (Yijishan Hospital) |
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是否获伦理委员会批准: |
是/Yes |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
(2026)伦审研第(64)号 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
皖南医学院弋矶山医院科研和新技术伦理委员会 |
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Name of the ethic committee: |
Scientific Research and New Technology of Wannan Medical College Yijishan Hospital IRB |
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伦理委员会批准日期: Date of approved by ethic committee: |
2026-04-03 00:00:00 |
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伦理委员会联系人: |
吴佩 |
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Contact Name of the ethic committee: |
Pei Wu |
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伦理委员会联系地址: |
安徽省芜湖市镜湖区赭山西路2号皖南医学院弋矶山医院6号楼3楼 |
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Contact Address of the ethic committee: |
3rd Floor, Building 6, Yijishan Hospital, Wannan Medical University, No. 2 Zheshan West Road, Jinghu District, Wuhu, Anhui Province, China |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 553 573 9209 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
shenqiqi@yjsyy.com |
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研究实施负责(组长)单位: |
皖南医科大学第一附属医院(弋矶山医院) |
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Primary sponsor: |
The First Affiliated Hospital of Wannan Medical University (Yijishan Hospital) |
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研究实施负责(组长)单位地址: |
安徽省芜湖市镜湖区赭山西路2号 |
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Primary sponsor's address: |
No. 2, Zheshan West Road, Jinghu District, Wuhu, Anhui Province, China |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
安徽省教育厅面上项目经费支持 |
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Source(s) of funding: |
Funding support from the General Program of the Education Department of Anhui Province. |
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Target disease: |
Post-stroke spastic hemiparesis / Post-stroke limb motor dysfunction |
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Target disease code: |
ICD-10:I69,; I69.1 I69.3 |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
其它 | ||||||||||||||||||||||
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Study phase: |
N/A |
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研究设计: |
单臂 |
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Study design: |
Single arm |
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研究目的: |
本研究旨在针对脑卒中后肢体痉挛性偏瘫或运动功能障碍患者,探索以小脑齿状核深部脑刺激(DN-DBS)联合脊髓电刺激(SCS)构建“小脑–脊髓接口”的安全性、可行性及潜在疗效。研究将评估 DN-DBS 联合 SCS 是否能够改善脑卒中后上肢运动功能和痉挛状态,并进一步验证 DN-DBS 是否可通过提高皮质脊髓束兴奋性、扩大 SCS 有效治疗参数窗口,从而增强神经调控促进肢体康复的效果。同时,本研究拟探索小脑齿状核电信号作为闭环刺激输入信号的应用价值,分析双侧 DN-DBS 对单侧卒中后功能代偿的影响,并采集健侧与患侧小脑齿状核电生理特征,为脑卒中后闭环神经调控和脑机接口康复策略提供理论依据和临床转化基础。 |
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Objectives of Study: |
This study aims to evaluate the safety, feasibility, and preliminary efficacy of a cerebellar–spinal interface based on combined dentate nucleus deep brain stimulation and spinal cord stimulation for post-stroke spastic hemiparesis. It further seeks to explore whether dentate nucleus stimulation enhances corticospinal excitability, expands the effective therapeutic parameter window of spinal cord stimulation, and promotes limb motor recovery through closed-loop neuromodulation. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1. 年龄18–70岁,男性或女性; 2. 经CT或MRI证实为缺血性或出血性脑卒中,原发病灶稳定,病程≥6个月,处于后遗症期,且接受传统康复治疗≥6个月后无明显功能改善; 3. 存在卒中后上肢运动功能障碍或痉挛性偏瘫,上肢Fugl-Meyer Assessment,FMA,评分≤42分,患肢改良Ashworth量表评分≥2级,瘫痪肢体主要肌群肌力≥1级; 4. 患侧肢体至少保留部分肌肉收缩能力,如手指微动或腕关节屈伸; 5. 简易精神状态检查,MMSE,评分≥26分,无明显认知障碍,能够理解并执行研究相关康复训练任务; 6. 无植入手术禁忌证,如无癫痫、无金属过敏、无严重脊柱畸形等; 7. 预期寿命>1年; 8. 患者家庭能够提供足够护理支持; 9. 能够并愿意遵守研究要求,参加术前评估,承诺完成≥12个月随访,并配合术后康复训练和居家访视; 10. 同意接受脑深部电极与脊髓刺激装置植入,并签署知情同意书。 |
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Inclusion criteria |
1. Male or female patients aged 18–70 years; 2. Diagnosis of ischemic or hemorrhagic stroke confirmed by CT or MRI, with a stable primary lesion, disease duration of ≥6 months, and no significant functional improvement after ≥6 months of conventional rehabilitation; 3. Post-stroke upper-limb motor dysfunction or spastic hemiparesis, defined as an upper-extremity Fugl-Meyer Assessment score ≤42, a Modified Ashworth Scale score ≥2 in the affected limb, and muscle strength ≥ grade 1 in the main muscle groups of the paretic limb; 4. Preserved partial muscle contraction in the affected limb, such as slight finger movement or wrist flexion/extension; 5. Mini-Mental State Examination score ≥26, without significant cognitive impairment, and able to understand and perform the scheduled rehabilitation tasks; 6. No contraindications to implantation, such as epilepsy, metal allergy, or severe spinal deformity; 7. Life expectancy >1 year; 8. Adequate family or caregiver support; 9. Ability and willingness to comply with all study requirements, complete all required preoperative assessments, commit to ≥12 months of follow-up, and cooperate with postoperative rehabilitation training and home visits; 10. Willingness to undergo implantation of deep brain stimulation and spinal cord stimulation devices and to provide written informed consent. |
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排除标准: |
1. 伴有严重失语症、感觉性失语或理解障碍; 2. 明确诊断为阿尔茨海默病、帕金森病等其他神经系统退行性疾病; 3. 有癫痫病史或卒中后癫痫发作; 4. 完全性运动通路中断,患肢完全无肌肉收缩功能; 5. 严重痉挛或关节挛缩,改良Ashworth量表评分≥3级,影响电刺激效果; 6. 体内存在其他可能干扰DBS或SCS的植入式电子设备; 7. 凝血功能障碍,INR>1.5,或血小板<80×10?/L;未控制的高血压,>160/100 mmHg,或糖尿病,HbA1c>9%;严重心肺功能不全,如NYHA心功能III–IV级或COPD GOLD 3–4级; 8. 偏瘫侧肢体存在骨折未愈合、严重关节炎或关节置换; 9. 严重脊柱畸形; 10. 免疫抑制或活动性感染,如HIV、梅毒、慢性骨髓炎等; 11. 严重抑郁症,HAMD≥17,或精神疾病史; 12. 妊娠或计划妊娠; 13. 预期生存期<1年; 14. 正在参加其他可能干扰本研究结果的临床试验。 |
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Exclusion criteria: |
1. Severe aphasia, sensory aphasia, or impaired comprehension; 2. Definite diagnosis of other neurodegenerative diseases, such as Alzheimer’s disease or Parkinson’s disease; 3. History of epilepsy or post-stroke epileptic seizures; 4. Complete interruption of the motor pathway with no residual muscle contraction in the affected limb; 5. Severe spasticity or joint contracture, defined as a Modified Ashworth Scale score ≥3, that may interfere with the effect of electrical stimulation; 6. Presence of other implanted electronic devices that may interfere with DBS and/or SCS; 7. Coagulation dysfunction, INR >1.5, or platelet count <80×10?/L; uncontrolled hypertension >160/100 mmHg or diabetes mellitus with HbA1c >9%; severe cardiopulmonary dysfunction, such as NYHA class III–IV heart failure or COPD GOLD stage 3–4; 8. Unhealed fracture, severe arthritis, or joint replacement in the paretic limb; 9. Severe spinal deformity; 10. Immunosuppression or active infection, such as HIV infection, syphilis, or chronic osteomyelitis; 11. Severe depression, HAMD ≥17, or history of psychiatric disorders; 12. Pregnancy or planned pregnancy; 13. Life expectancy <1 year; 14. Participation in another clinical trial that may interfere with the results of this study. |
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研究实施时间: Study execute time: |
从 From 2026-01-01 00:00:00至 To 2028-12-31 00:00:00 |
征募观察对象时间: Recruiting time: |
从From 2026-06-01 00:00:00 至 To 2027-12-31 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
本研究为开放、随机、单臂、自身对照探索性研究,不涉及受试者在不同平行组之间的随机分配。随机化仅用于每名受试者 DN-DBS 短期开机/关机区块顺序的分配。由不参与疗效评估的独立研究人员或统计人员采用随机数表法或计算机随机数字生成方法,为每名受试者生成 DN-DBS 开/关随机盲区块序列。每名受试者包含6个区块,每个区块7天,区块状态为 DN-DBS 开机或关机/伪刺激。随机序列由专人保存,程控人员按序列执行,评估人员尽量保持盲法。 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
This is an open-label, randomized, single-arm, within-subject controlled exploratory study. No random allocation of participants to parallel groups will be performed. Randomization will only be applied to the order of short-term DN-DBS ON/OFF blocks within each participant. An independent researcher or statistician who is not involved in outcome assessment will generate the randomized DN-DBS ON/OFF block sequence for each participant using a random number table or a computer-generated randomization method. Each participant will undergo six 7-day blocks, with each block assigned to DN-DBS ON or OFF/sham stimulation. The randomization sequence will be kept by designated personnel, implemented by the programming staff, and outcome assessors will be kept blinded whenever feasible. |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
公开/Public |
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盲法: |
无 |
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Blinding: |
None |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
Yes |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
本研究涉及侵入式神经调控、脑深部电刺激、脊髓电刺激、神经电生理、影像学及临床功能评估等敏感个体数据,原则上不公开共享可识别的个体原始数据。研究完成并发表主要研究结果后,经受试者知情同意允许、伦理委员会批准及签署数据使用协议,可在合理申请基础上向合格研究者提供去标识化后的研究数据、数据字典、研究方案及统计分析计划。共享内容不包括可识别个人身份的信息、原始影像中的身份信息、未经处理的植入设备敏感参数及可能影响受试者隐私和安全的数据。共享时间为主要研究结果发表后6个月起,原则上开放至发表后5年。申请方式为向主要研究者或项目承担单位提交书面申请,经研究团队和伦理委员会审核后提供。 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
Because this study involves sensitive individual-level data related to invasive neuromodulation, deep brain stimulation, spinal cord stimulation, neurophysiology, neuroimaging, and clinical functional assessments, identifiable individual participant data will not be publicly shared. After completion of the study and publication of the main results, de-identified research data, the data dictionary, study protocol, and statistical analysis plan may be made available to qualified researchers upon reasonable request, subject to participants’ informed consent, ethics committee approval, and execution of a data use agreement. Shared data will exclude personally identifiable information, identifiable imaging information, sensitive raw device parameters, and any data that may compromise participant privacy or safety. Data sharing will be available from 6 months after publication of the main results and, in principle, for up to 5 years. Requests should be submitted in writing to the principal investigator or the study institution and will be reviewed by the research team and ethics committee. |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
本研究将建立标准化病例报告表(CRF)和电子数据采集与管理系统(EDC)相结合的数据管理体系。CRF用于记录受试者筛选、知情同意、基线资料、纳入/排除标准、手术信息、刺激参数、康复训练情况、不良事件、随访记录及各时间点结局指标。EDC系统用于录入、核查、存储和管理电子化研究数据。所有受试者将采用唯一研究编号管理,个人身份信息与研究数据分开保存。研究数据包括临床量表评分、运动功能评估、运动诱发电位、感觉诱发电位、握力曲线、肩肘腕扭矩和运动轨迹、脑皮质-颈髓联合fMRI、DTI、MRS、小脑齿状核局部场电位、SCS有效治疗参数窗口、DN-DBS/SCS程控参数及安全性事件等。数据由经过培训的研究人员采集和录入,设立数据核查、逻辑校验、缺失值核对和定期质控流程。纸质CRF由专人保管,电子数据采用权限分级、密码保护、定期备份和访问日志管理。研究结束后,数据将按照伦理委员会和临床研究管理要求保存。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
A standardized data management system combining case report forms (CRFs) and an electronic data capture (EDC) system will be established. CRFs will be used to record participant screening, informed consent, baseline information, inclusion/exclusion criteria, surgical information, stimulation parameters, rehabilitation training, adverse events, follow-up records, and outcome measures at predefined time points. The EDC system will be used for electronic data entry, verification, storage, and management. Each participant will be assigned a unique study identification number, and personal identifying information will be stored separately from research data. The collected data will include clinical scale scores, motor function assessments, motor evoked potentials, somatosensory evoked potentials, grip-force curves, shoulder/elbow/wrist torque and movement trajectories, combined cortico-cervical spinal fMRI, DTI, MRS, dentate nucleus local field potentials, the effective therapeutic parameter window of SCS, DN-DBS/SCS programming parameters, and safety events. Data will be collected and entered by trained research personnel. Data verification, logical checks, missing-data review, and regular quality control procedures will be implemented. Paper CRFs will be stored by designated personnel, and electronic data will be protected by role-based access control, password protection, regular backup, and access logs. Study data will be retained according to ethics committee and clinical research management requirements after study completion. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
暂未确定/Not yet |