双侧小脑齿状核脑深部电刺激(DN-DBS)治疗卒中后肢体功能障碍的疗效及影响因素分析

注册号:

Registration number:

ChiCTR2600121668 

最近更新日期:

Date of Last Refreshed on:

2026-04-01 16:23:42 

注册时间:

Date of Registration:

2026-04-01 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

双侧小脑齿状核脑深部电刺激(DN-DBS)治疗卒中后肢体功能障碍的疗效及影响因素分析

Public title:

Efficacy and predictors of bilateral dentate nucleus deep brain stimulation (DN-DBS) for post-stroke limb motor impairment: a prospective single-arm pilot interventional study

注册题目简写:

双侧齿状核DBS卒中后偏瘫先导研究

English Acronym:

Bilateral dentate nucleus DBS for post-stroke hemiparesis: a pilot study

研究课题的正式科学名称:

双侧小脑齿状核脑深部电刺激(DN-DBS)治疗卒中后肢体功能障碍的疗效及影响因素分析

Scientific title:

Efficacy and predictors of bilateral dentate nucleus deep brain stimulation (DN-DBS) for post-stroke limb motor impairment: a prospective single-arm, assessor-blinded endpoint pilot study

研究课题代号(代码):

Study subject ID:

DNDBS-PSMI-IIT-2026

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:

申请注册联系人:

刘长青 

研究负责人:

刘长青 

Applicant:

Changqing Liu 

Study leader:

Changqing Liu 

申请注册联系人电话:

Applicant telephone:

+86 151 0106 4296

研究负责人电话:

Study leader's
telephone:

+86 151 0106 4296

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

liuchangqing409@163.com

研究负责人电子邮件:

Study leader's E-mail:

liuchangqing409@163.com

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):

申请注册联系人通讯地址:

北京市朝阳区工体南路8号

研究负责人通讯地址:

北京市朝阳区工体南路8号

Applicant address:

8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing

Study leader's address:

8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing

申请注册联系人邮政编码:

Applicant postcode:

100020

研究负责人邮政编码:

Study leader's postcode:

100020

申请人所在单位:

首都医科大学附属北京朝阳医院

Applicant's institution:

Beijing Chao-Yang Hospital, Capital Medical University

研究负责人所在单位:

首都医科大学附属北京朝阳医院

Affiliation of the Leader:

Beijing Chao-Yang Hospital, Capital Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2026-科-52-1

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

首都医科大学附属北京朝阳医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Beijing Chao-Yang Hospital, Capital Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-02-14 00:00:00

伦理委员会联系人:

吕亚丽

Contact Name of the ethic committee:

Yali Lu

伦理委员会联系地址:

北京市朝阳区工体南路8号

Contact Address of the ethic committee:

8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 10 8523 1484

伦理委员会联系人邮箱:

Contact email of the ethic committee:

cyylunli2019@163.com

研究实施负责(组长)单位:

首都医科大学附属北京朝阳医院

Primary sponsor:

Beijing Chao-Yang Hospital, Capital Medical University

研究实施负责(组长)单位地址:

北京市朝阳区工体南路8号

Primary sponsor's address:

8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

北京

市(区县):

朝阳区

Country:

China

Province:

Beijing

City:

Chaoyang District

单位(医院):

首都医科大学附属北京朝阳医院

具体地址:

北京市朝阳区工体南路8号

Institution
hospital:

Beijing Chao-Yang Hospital, Capital Medical University

Address:

8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing

经费或物资来源:

景昱医疗科技(苏州)股份有限公司提供部分植入器械无偿科研支持(电极、延伸导线、体外充电器等);其余费用按医院常规路径与医保政策执行;研究责任保险由研究团队按院内合规流程统一购买。

Source(s) of funding:

Partial in-kind support of implantable devices (e.g., leads, extension cables, external charger) is provided by SceneRay Co., Ltd. (Suzhou). Other costs follow standard hospital procedures and insurance policies. Trial liability insurance will be purchased by the research team per institutional compliance requirements.

研究疾病:

卒中后肢体功能障碍(慢性期偏瘫)  

Target disease:

Post-stroke limb motor impairment (chronic hemiparesis)

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

探索性研究/预试验 

Study phase:

0

研究设计:

单臂 

Study design:

Single arm 

研究目的:

验证DN-DBS联合标准化康复治疗慢性期卒中偏瘫的安全性与初步有效性;估计主要结局效应量与方差;探索与疗效相关的临床/影像/电生理候选影响因素,为后续多中心确证性研究提供依据。  

Objectives of Study:

To evaluate safety and preliminary efficacy of DN-DBS combined with standardized rehabilitation in chronic post-stroke hemiparesis; to estimate effect size and variance for the primary outcome; and to explore candidate clinical, imaging, and electrophysiological predictors to inform future multicenter confirmatory trials.

药物成份或治疗方案详述:

所有受试者植入双侧小脑齿状核DBS电极与脉冲发生器(IPG)。术后约4周首次开机程控,默认先启用病灶对侧单侧刺激,采用“低起点、小步递增、以疗效与耐受为导向”的个体化参数优化(幅度/频率/脉宽)。完成开机后3个月评估且耐受良好后,按方案切换为双侧刺激,持续至开机后6个月终末访视。全程提供统一标准化康复(任务导向上肢训练、PT/OT等),并记录康复剂量与依从性。 

Description for medicine or protocol of treatment in detail:

All participants undergo implantation of bilateral dentate nucleus DBS leads and an implantable pulse generator (IPG). Initial programming is performed about 4 weeks postoperatively. Contralesional unilateral stimulation is applied first, with individualized parameter optimization (amplitude/frequency/pulse width) using a low-start, slow-titration, efficacy-and-tolerability–guided approach. After the 3-month post-activation assessment and confirmed tolerability, stimulation is switched to bilateral and continued until the 6-month post-activation final visit. Standardized rehabilitation (task-oriented upper-limb training, PT/OT) is delivered throughout, with rehabilitation dose and adherence recorded. 

纳入标准:

Inclusion criteria

排除标准:

1.严重吞咽障碍或反复误吸/吸入性肺炎; 2.双侧小脑广泛病变,或齿状核/上小脑脚/DRTT被病灶直接破坏; 3.手术/麻醉禁忌(严重心肺功能不全、未控制高血压、凝血障碍等); 4.未控制的精神疾病或重度认知损害; 5.妊娠/哺乳或研究期计划妊娠; 6.与DBS可能干扰的其他有源植入器械且无法确保兼容; 7.近6个月反复癫痫大发作或合并严重其他神经系统疾病; 8.严重内科合并症(活动性肿瘤、严重肝肾衰竭等); 9. 正在或近期参加其他可能干扰结果的临床试验; 10.研究者判断不适合入组的其他情况。

Exclusion criteria:

1. Severe swallowing disorder or repeated aspiration/inhalation pneumonia; 2. Extensive bilateral cerebellar lesions, or the dentate nucleus/superior cerebellar peduncle/DRTT directly damaged by the lesion; 3. Surgical/anesthesia contraindications (severe cardiopulmonary insufficiency, uncontrolled hypertension, coagulation disorders, etc.); 4. Uncontrolled psychiatric disorders or severe cognitive impairment; 5. Pregnancy/lactation or planning pregnancy during the study period; 6. Other active implanted devices that may interfere with DBS and cannot ensure compatibility; 7. Repeated generalized seizures in the past 6 months or combined with other severe neurological diseases; 8. Severe internal medical comorbidities (active tumor, severe liver or renal failure, etc.); 9. Currently or recently participating in other clinical trials that may interfere with results; 10. Other conditions deemed unsuitable for enrollment by the investigator.

研究实施时间:

Study execute time:

From 2026-03-01 00:00:00 To 2027-07-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-04-01 00:00:00 To 2027-01-01 00:00:00

干预措施:

Interventions:

组别:

单组(单臂)

样本量:

15

Group:

Single arm

Sample size:

干预措施:

所有受试者植入双侧小脑齿状核DBS电极与脉冲发生器(IPG)。术后约4周首次开机程控,默认先启用病灶对侧单侧刺激,采用“低起点、小步递增、以疗效与耐受为导向”的个体化参数优化(幅度/频率/脉宽)。完成开机后3个月评估且耐受良好后,按方案切换为双侧刺激,持续至开机后6个月终末访视。全程提供统一标准化康复(任务导向上肢训练、PT/OT等),并记录康复剂量与依从性。

干预措施代码:

Intervention:

All participants undergo implantation of bilateral dentate nucleus DBS leads and an implantable pulse generator (IPG). Initial programming is performed about 4 weeks postoperatively. Contralesional unilateral stimulation is applied first, with individualized parameter optimization (amplitude/frequency/pulse width) using a low-start, slow-titration, efficacy-and-tolerability–guided approach. After the 3-month post-activation assessment and confirmed tolerability, stimulation is switched to bilateral and continued until the 6-month post-activation final visit. Standardized rehabilitation (task-oriented upper-limb training, PT/OT) is delivered throughout, with rehabilitation dose and adherence recorded.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

北京市 

市(区县):

朝阳区 

Country:

China

Province:

Beijing

City:

Chaoyang District

单位(医院):

首都医科大学附属北京朝阳医院 

单位级别:

三甲 

Institution
hospital:

Beijing Chaoyang Hospital, Capital Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

Fugl-Meyer 运动功能评分总分变化量(ΔFMA)

指标类型:

主要指标

Outcome:

Change in total Fugl–Meyer Assessment motor score (ΔFMA)

Type:

Primary indicator

测量时间点:

术前基线(V0);开机后3个月(V3);开机后6个月(V4)【主要终点:V4相对V0变化量】

测量方法:

采用标准化 FMA 评定流程,由与手术/程控隔离的评估者完成,必要时双评+仲裁;以“开机后6个月?术前基线”的差值计算ΔFMA。

Measure time point of outcome:

Baseline (preoperative, V0); 6 months after stimulation activation (V4, primary endpoint)

Measure method:

Standardized FMA administered by assessors blinded to surgery/programming; dual rating with adjudication if needed. ΔFMA calculated as (6 months post-activation ? baseline).

指标中文名:

改良Ashworth量表评分(MAS,上下肢肌张力/痉挛)

指标类型:

次要指标

Outcome:

Modified Ashworth Scale (MAS) score for spasticity/muscle tone (upper and lower limbs)

Type:

Secondary indicator

测量时间点:

术前基线(V0);开机后3个月(V3);开机后6个月(V4)

测量方法:

按标准化被动牵伸评定流程评分。

Measure time point of outcome:

Baseline (V0); 3 months post-activation (V3); 6 months post-activation (V4).

Measure method:

Scored per standardized passive stretch assessment procedure.

指标中文名:

FMA 分维度评分(上肢/下肢、近端/远端、协调与平衡等)

指标类型:

次要指标

Outcome:

FMA domain/subscores (UE/LE; proximal/distal; coordination/balance)

Type:

Secondary indicator

测量时间点:

术前基线(V0);开机后3个月(V3);开机后6个月(V4)

测量方法:

基于标准化FMA评估结果提取各分维度得分并记录变化。

Measure time point of outcome:

Baseline (V0); 3 months post-activation (V3); 6 months post-activation (V4).

Measure method:

Derived from standardized FMA assessments; subscores recorded per manual.

指标中文名:

多伦多康复研究所手功能测试(TRI-HFT)得分

指标类型:

次要指标

Outcome:

Toronto Rehabilitation Institute Hand Function Test (TRI-HFT) score

Type:

Secondary indicator

测量时间点:

术前基线(V0);开机后3个月(V3);开机后6个月(V4)

测量方法:

按TRI-HFT标准化操作流程完成任务并计分,由非治疗决策评估者执行。

Measure time point of outcome:

Baseline (V0); 3 months post-activation (V3); 6 months post-activation (V4).

Measure method:

Scored per standardized TRI-HFT task procedure by trained assessors not involved in treatment decisions.

指标中文名:

医院焦虑抑郁量表(HADS)总分及分量表(HADS-A/HADS-D)

指标类型:

次要指标

Outcome:

Hospital Anxiety and Depression Scale (HADS) total and subscale scores (HADS-A/HADS-D)

Type:

Secondary indicator

测量时间点:

术前基线(V0);开机后3个月(V3);开机后6个月(V4)

测量方法:

受试者按量表说明自评填写(必要时指导),按标准计分规则计算得分。

Measure time point of outcome:

Baseline (V0); 3 months post-activation (V3); 6 months post-activation (V4).

Measure method:

Self-reported questionnaire scored per standard HADS scoring rules.

指标中文名:

视觉模拟评分(VAS,疼痛/不适 0–10分)

指标类型:

次要指标

Outcome:

Visual Analog Scale (VAS) score for pain/discomfort (0–10)

Type:

Secondary indicator

测量时间点:

术前基线(V0);开机后3个月(V3);开机后6个月(V4)

测量方法:

受试者按0–10分VAS标准说明进行主观评分并记录。

Measure time point of outcome:

Baseline (V0); 3 months post-activation (V3); 6 months post-activation (V4).

Measure method:

Patient-reported VAS (0–10) recorded per standard instructions.

指标中文名:

SF-36 健康相关生活质量量表(各维度得分)

指标类型:

次要指标

Outcome:

Short Form-36 Health Survey (SF-36) domain scores

Type:

Secondary indicator

测量时间点:

术前基线(V0);开机后3个月(V3);开机后6个月(V4)

测量方法:

受试者按SF-36标准问卷填写并按规范换算各维度0–100分。

Measure time point of outcome:

Baseline (V0); 3 months post-activation (V3); 6 months post-activation (V4).

Measure method:

SF-36 administered and scored per validated standard procedures (domain scores 0–100).

指标中文名:

影像学及/或电生理探索性指标(MRI/DTI/静息态fMRI/PET-CT/MEP等)

指标类型:

附加指标

Outcome:

Exploratory imaging and electrophysiology measures (MRI/DTI/rs-fMRI/PET-CT/MEP), as available

Type:

Additional indicator

测量时间点:

术前(基线);随访阶段(与V3/V4同步或条件允许时)

测量方法:

按常规采集流程获取数据并进行探索性分析,与临床结局相关性分析。

Measure time point of outcome:

Pre-operation baseline; follow-up visits when feasible (aligned with V3/V4 where applicable).

Measure method:

Acquired per standard protocols; analyzed exploratorily and correlated with clinical outcomes.

指标中文名:

不良事件/严重不良事件(AE/SAE,与手术/电刺激/康复相关)

指标类型:

副作用指标

Outcome:

Adverse events (AEs) and serious adverse events (SAEs) related to surgery/stimulation/rehabilitation

Type:

Adverse events

测量时间点:

入组至随访结束全程;每次随访均记录(含V0、V3、V4及非计划访视)

测量方法:

全程主动监测与记录,按方案定义分级、判定相关性并报告。

Measure time point of outcome:

Continuous from enrollment to end of follow-up; reviewed at each scheduled/unscheduled visit (including V0/V3/V4).

Measure method:

Systematically collected throughout the study and at each visit; graded and reported per protocol definitions.

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

None

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

None

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 80 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

不适用(单臂研究)

Randomization Procedure (please state who generates the random number sequence and by what method):

Not applicable (single-arm study)

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

盲法:

治疗开放;终点评估盲化(评估者不参与手术/程控/康复决策;可采用标准化视频、去标识化编码、双评+仲裁)。

Blinding:

Open-label treatment; assessor-blinded endpoints (assessors separated from surgery/programming/rehabilitation decisions; standardized video capture, de-identification, dual rating with adjudication as needed).

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

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):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

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:

数据采集:采用纸质CRF/原始评估表(量表评分表、康复记录、不良事件记录等)与医院信息系统/检查报告作为源数据;关键运动功能评估采用标准化视频采集与编码入库。数据管理:采用电子数据采集系统(EDC/eCRF,具备权限管理、逻辑核查与审计追踪),执行数据疑问(Query)管理、定期备份与锁库流程;所有数据去标识化后进入统计分析数据集(FAS/PPS/SS)。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection: source data include paper CRFs/original assessment forms (scale score sheets, rehabilitation logs, AE/SAE forms) and hospital information system reports; key motor assessments are captured on standardized video and stored with coded identifiers. Data management: an electronic data capture system (EDC/eCRF) with role-based access, logic checks, and audit trails will be used, with query management, regular backups, and database lock procedures. Data will be de-identified for analysis datasets (FAS/PPS/SS).

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2026-04-01 16:23:08