The Transcutaneous Electrical Spinal Cord Neuromodulation (TESCoN) Trial
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.
