A potentially game-changing intervention...
An exciting clinical trial of transcutaneous electrical spinal cord neuromodulation (TESCoN) is underway at the Royal Talbot Hospital in Kew, Victoria (ACTRN12622000145707).
What is Transcutaneous Electrical Spinal Cord Neuromodulation (TESCoN)?
Transcutaneous Electrical Spinal Cord Neuromodulation (TESCoN) is a cutting-edge, non-invasive technique designed to enhance nerve function using electrical stimulation, all without the need for surgery. By placing electrodes on the skin over the spinal column, TESCoN delivers a controlled electrical current to the spinal cord. This current targets spinal pathways that, while still intact, aren't functioning optimally due to injury.
TESCoN works by modulating key spinal networks, including:
- Central Pattern Generators: These networks produce rhythmic motor patterns like walking.
- Propriospinal System: This system connects different spinal segments and helps control movements of the limbs and trunk.
By increasing the baseline excitability of the spinal circuitry below the injury, TESCoN enables the spinal cord to respond to lower levels of stimulation, thus facilitating movement.
Although TESCoN alone doesn’t lead to complete functional recovery, it significantly boosts the effectiveness of intensive rehabilitation. This combination fosters activity-dependent plasticity, a process where repeated practice enhances motor function through adjustments in the spinal networks involved in movement control.
Recent studies have demonstrated that combining TESCoN with intensive rehabilitation can notably improve upper limb function in individuals with chronic tetraplegia.
What makes this study different?
- Non-Invasive: Avoids the need for surgery, making it accessible to a wider range of patients.
- Enhanced Functionality: Has the potential to improve upper limb and trunk function by boosting spinal cord excitability, which could lead to better motor control and increased independence.
- Synergistic Effect: When combined with intensive rehabilitation, TESCoN promotes lasting recovery more effectively than rehabilitation alone.
- Broader Benefits: Potential to improve autonomic function and trunk stability, in addition to upper limb function.
- Leverages Neuro-plasticity: Includes recently injured patients - a group often neglected in spinal cord injury research.
- Challenging Norms: This innovative approach contests the belief that complete spinal cord injury (SCI) results in irreversible loss of function, offering new hope for individuals with chronic SCI.
And a unique Basket Trial Design...
Our study uses a basket trial design with four distinct participant groups, organized by:
- Injury Severity: AIS A/B or AIS C/D
- Stage of Recovery:
- Sub-acute (3-6 months post-injury)
- Chronic (more than 12 months post-injury)
The trial follows the Bayesian Optimal Phase IIa (BOP2) decision-making framework. This includes three interim assessment points after recruiting 5, 10, and 15 participants, with a final evaluation once 20 participants have been enrolled. This structured approach helps ensure rigorous evaluation of the intervention’s effectiveness and safety throughout the study.
Ongoing research aims to refine its application and explore its full potential, making TESCoN a game-changing intervention in SCI management.
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Interested in joining the TESCoN Trial or learning more?
Contact: Dr. Maya Panisset, TESCoN Trial Coordinator
- maya.panisset@unimelb.edu.au
- Phone
- +61 405 027 127
- Address
- TESCoN Research Study, Room 1.272, Level 1, Royal Talbot Rehabilitation Hospital, Austin Health, KEW, VIC, 3101
The TESCoN trial is led by Professor Mary Galea. This project is funded by the Australian Medical Research Future Fund.
This project is approved by the Human Research Ethics Committee of Austin Health (Project #83605)
What is the trial like?
Participants in the TESCoN program faced mental and physical challenges, but many discovered new strength, resilience, and optimism along the way.
“TESCoN has been nothing but beneficial, both physically and mentally. Before TESCoN, I didn’t think I would gain any further improvements." – Participant
Approaching the program with openness and curiosity, several participants found the experience deeply rewarding:
“I went into the program with an open mind, not expecting anything magical, but I was really impressed. I enjoyed the experience, and the gains I made were definitely worth the investment.” – Participant
Physical progress was a common theme, as participants noticed significant improvements in mobility and strength:
“My arms are stronger, which means I can go further and faster in my wheelchair. I’m less fatigued. Before TESCoN, I needed a hoist for transfers. Now, I can transfer 50% of the time without a hoist.” - Participant
Despite the intensity of the program, TESCoN provided participants with the tools to regain independence, improve quality of life, and, above all, restore hope.
Is TESCoN Right for you?
The TESCoN program is designed for individuals with tetraplegia (quadriplegia) below the C4 level as a result of a traumatic spinal cord injury.
You may be eligible if:
- Your injury occurred 3-6 months ago, or over 12 months ago
- You are aged between 15 and 75 years
- You do not have any other neurological conditions
- You have not undergone upper limb tendon or nerve transfer surgery
What to Expect if You Participate
If you choose to participate in the TESCoN research study, your journey will begin with an initial screening, medical clearance, and assessments at the Royal Talbot Rehabilitation Centre.
Following the screening, you’ll attend therapy sessions Monday through Friday for 4 weeks, where you will receive TESCoN treatment alongside intensive physiotherapy for your arms and hands. Your progress will be assessed after the intervention and again three months later.
Time Commitment
- Assessments: Approximately 4-5 hours
- Therapy Sessions: 1-2 hours per session, five days a week for 4 weeks
Reimbursement
While you won’t be paid for participating, you will be reimbursed for reasonable expenses such as travel, parking, and refreshments during your time in the study.
Interested in joining the TESCoN Trial or learning more?
Contact: Dr. Maya Panisset, TESCoN Trial Coordinator
- maya.panisset@unimelb.edu.au
- Phone
- +61 405 027 127
- Address
- TESCoN Research Study, Room 1.272, Level 1, Royal Talbot Rehabilitation Hospital, Austin Health, KEW, VIC, 3101
The TESCoN trial is led by Professor Mary Galea. This project is funded by the Australian Medical Research Future Fund.
This project is approved by the Human Research Ethics Committee of Austin Health (Project #83605)
Key Media & Articles
- AQA Article - More Participants Needed for Spinal Cord Stimulation Trial (July 2024)
- University of Melbourne: Advancing Health 2030 – Trial shows early impact for spinal injury patients (Dec 2022)
- Channel 9 News Report – New device to help people with severe spinal injuries regain movement (Nov 2022)
- Austin Health Media Release – Spinal call to arms (Nov 2022)
- AQA Article – Spinal Cord Stimulation, minus the surgery and implant (Aug 2022)
Interested in joining the TESCoN Trial or learning more?
Contact: Dr. Maya Panisset, TESCoN Trial Coordinator
- maya.panisset@unimelb.edu.au
- Phone
- +61 405 027 127
- Address
- TESCoN Research Study, Room 1.272, Level 1, Royal Talbot Rehabilitation Hospital, Austin Health, KEW, VIC, 3101
The TESCoN trial is led by Professor Mary Galea. This project is funded by the Australian Medical Research Future Fund.
This project is approved by the Human Research Ethics Committee of Austin Health (Project #83605)
Interested in joining the TESCoN Trial or learning more?
Contact: Dr. Maya Panisset, TESCoN Trial Coordinator
- maya.panisset@unimelb.edu.au
- Phone
- +61 405 027 127
- Address
- TESCoN Research Study, Room 1.272, Level 1, Royal Talbot Rehabilitation Hospital, Austin Health, KEW, VIC, 3101