The purpose of this clinical trial is to assess the preliminary safety and efficacy of the ARC-IM spinal cord stimulation therapy in alleviating locomotor deficits in individuals with Parkinson's disease. The ARC-IM Therapy employs epidural electrical stimulation (EES) to modulate leg muscle recruitment, with the aim of improving mobility deficits. The ultimate goal is to enhance the quality of life of people with Parkinson's disease.
The progression of Parkinson's Disease (PD) is often marked by the development of severe locomotor deficits, including gait impairments, which significantly affect patients' independence and are not effectively addressed by current treatments. The STIMO-PARKINSON (NCT04956770) clinical trial has shown promising results with epidural electrical stimulation (EES) in significantly reducing these locomotor deficits in Parkinson's Disease patients. Building on these findings, the SPARKL clinical study aims to further this research. The SPARKL study aims to enroll six individuals with advanced Parkinson's Disease to assess the safety and efficacy of the novel ARC-IM Therapy. This new therapy has been designed to overcome previous technological limitations and facilitate its home-use. This study will take place at the Lausanne University Hospital (CHUV, Switzerland). The total duration of the study is 4 years per participant. The study intervention consists of several phases preceded by pre-screening. The first year involves an intensive participation, consisting of the following phases: enrolment and baseline, surgical implantation of the stimulation device, a main study phase that includes stimulation configuration sessions and both in-clinic and at-home rehabilitation, and finally the home-use phase. This will be succeeded by 3 years of safety follow-up, during which the participant can use the stimulation device in their daily life, subject to investigator approval. Throughout the study, the investigators will conduct assessments at various stages of each participant's journey in the study. These assessments will be used to assess the preliminary safety and efficacy of the ARC-IM therapy at alleviating locomotor deficits.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Implantation of a stimulation lead on the lumbar level of the spinal cord and implantation of a neurostimulator in the abdominal region.
Centre Hospitalier Universitaire Vaudois (CHUV)
Lausanne, Canton of Vaud, Switzerland
RECRUITINGOccurrence of serious adverse events and adverse events that are deemed related or possibly related to the study procedures or to the investigational system.
Assess the safety of the ARC-IM Therapy at alleviating locomotor deficits in people with Parkinson's Disease.
Time frame: From enrollment until end of safety follow-up phase (4 years)
10-meter walk test
To assess gait speed. Measurement tool: time (s)
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
6-minute walk test
To assess endurance. Measurement tool: distance (m)
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
Timed up and Go and its cognitive version
To assess freezing of gait prevalence. Measurement tool: time (s)
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
Freezing of gait circuit
To assess freezing of gait prevalence. Measurement tool: time (s)
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
Kinematic analysis
Gait circuit to assess gait kinematic. Measurement tool: changes in position and orientation of the body through sensors (mm)
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
Muscle analysis
Gait circuit to assess muscle activity. Measurement tool: muscle activity through sensors (mV)
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
Mini Balance Evaluation Systems Test (mini-BESTest)
4-item test to assess balance. Measurement tool: total score
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III
19 item-test to assess the course of Parkinson's Disease. Measurement tool: total score from 0 up to 132. Low score means a better outcome.
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
King's Parkinson's disease Pain Scale (KPPS)
7-item questionnaire to assess daily life performance. Measurement tool: total score 0 up to 168. Low score means a better outcome.
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
The Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part IA & IV Part I, II & IV.
3-part questionnaire to assess daily life performance. Measurement tool: total score from 0 up to 128. Low score means a better outcome.
Time frame: Baseline (before surgery), Short-Term assessments (~1 month post-surgery) and Follow-Up assessments (~4 & 11 months post-surgery)
Parkinson's Disease Questionnaire-39 (PDQ-39)
39-item questionnaire to assess daily life performance. Measurement tool: total score from 0 up to 100. Low score means a better outcome.
Time frame: Monthly, from the start of the study until the end of the home-use phase (~12 months)
Activities specific Balance Confidence Questionnaire (ABC-Q)
16-item questionnaire to assess daily life performance. Measurement tool: total score from 0 up to 100. High score means a better outcome.
Time frame: Monthly, from the start of the study until the end of the home-use phase (~12 months)
The Freezing of Gait Questionnaire (FOG-Q)
6-item questionnaire to assess daily life performance. Measurement tool: total score 0 up to 24. High score means a better outcome.
Time frame: Monthly, from the start of the study until the end of the home-use phase (~12 months)
Home-use kinematic monitoring
To assess gait pattern in ecological environment. Measurement tool: changes in position and orientation of the feet through sensors placed on shoes (mm)
Time frame: Weekly, from the start of the study until the end of the home-use phase (~12 months)
Daily falls tracking
To assess daily falls. Measurement tool: number of falls
Time frame: Weekly, from the start of the study until the end of the home-use phase (~12 months)
Satisfaction questionnaire
16-item questionnaire to collect feedback from the therapy. Measurement tool: total score from 0 up to 100.
Time frame: Monthly, from the Short-Term assessments (~1 month post-surgery) until the end of the home-use phase (~12 months)
User Evaluation of Satisfaction with technology (QUEST 2.0)
12-item questionnaire to assess usability of the therapy. Measurement tool: total score from 12 up to 60. Low score means a better outcome.
Time frame: Follow-Up assessments (~4 & 11 months post-surgery)
System Usability Scale (SUS)
Questionnaire to assess usability of the therapy. Measurement tool: total score from 0 to 100. High score means a better outcome.
Time frame: Follow-Up assessments (~4 & 11 months post-surgery)
Montreal Cognitive assessment (MoCA)
30-item test to assess global cognitive function across multiple domains including memory, attention, language, and executive function. Measurement tool: total score from 0 up to 30. High score means a better outcome.
Time frame: Baseline (before surgery), Follow-Up assessments (~4 & 11 months post-surgery) and safety follow-up visits.
Patient Global Impression of Change (PGI-C)
7-point single-item scale assessing the patient's self-reported overall change since the start of treatment. Measurement tool: score from 1 to 7. Low score means a better outcome.
Time frame: Short-Term assessments (~1 month post-surgery), Follow-Up assessments (~4 & 11 months post-surgery), and safety follow-up visits.
Semi-structured interview
Investigator-conducted interview assessing the participant's subjective well-being and the general effect of the therapy on daily life. Measurement tool: qualitative data.
Time frame: Short-Term assessments (~1 month post-surgery), Follow-Up assessments (~4 & 11 months post-surgery), and safety follow-up visits.
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