Multiple Sclerosis Clinical Trial
Official title:
Exploring the Use of Non-invasive Neuromodulation Combined With Exercise in People With Advanced Multiple Sclerosis (MS)
The investigators hypothesis is that electrical stimulation to the tongue that directly stimulates two cranial nerve nuclei (Trigeminal and Facial Nerve Nuclei), will excite neural impulses to the brainstem and cerebellum. The investigators call this cranial nerve non-invasive neuromodulation (CN-NINM). The activation of these structures induces neuroplasticity when combined with specific physical exercises, can reduce symptoms of advanced MS, targeting primarily postural stability (sitting and standing), upper extremity movement, and ability to perform self-transfers.
The intervention will be similar to that used in the investigators previous work with
movement disorders, and will be tailored to the address issues unique to individuals with
advanced MS.
The study will enroll a total of 6 subjects having advanced MS that present with significant
seated and standing balance, posture, or movement control deficits due to MS.
Subjects will complete twice-daily lab training for two weeks (5 days/week). Each lab
training (morning and afternoon) includes 1.5 to 2 hours of instruction in balance, posture
and gait activities; therapeutic exercise for isolated muscle control; transfer training; and
relaxation training.
Activities are performed in 20-minute sessions with concomitant electrical stimulation of the
tongue. The intervention is customized according to each subject's particular symptoms and
tolerance. If a subject is not able to perform this amount of training, the training will be
adapted to a level that is tolerable.
After these 2 weeks, subjects will continue to perform these same intervention activities at
home for 4 weeks. They will return to the lab for 1 week of training and testing, then
perform home training for 4 weeks. This cycle is repeated for a total of 5 cycles.
After the 6 months have been completed, subjects may choose to participate in an optional
second phase of the study. The second phase includes an additional 12 months of participation
in which subjects perform the intervention activities at home training and return to the lab
on time per month for 2 hours of testing and 2 hours of training.
If successful, this study would indicate that CN-NINM intervention may reduce the symptoms of
advanced MS.
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