Neuromuscular Electrical Stimulation on Median Nerve Facilitates Low Motor Cortex Excitability in Human With Spinocerebellar Ataxia

Study Overview
=================
Brief Summary
-----------------
Spinocerebellar ataxia (SCA) is a hereditary disorder with movement incoordination. The ataxia performed low intra-cortical facilitation mainly due to the degenerative cerebellum. Noninvasive sensory stimulations such as peripheral electrical stimulation were reported to modulate the excitability of the motor excitability. Neuromuscular electrical stimulation (NMES) was proposed as a neuromodulation tool for the aberrant motor excitability on the SCA. This study aims to investigate the effect of NMES on the motor excitability in the SCA, and the differentiation on the central or peripheral motor excitability changed by the NMES.

Conditions
-----------------
Spinocerebellar Ataxia

Intervention / Treatment
-----------------
* Device: Neuromuscular electrical stimulation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Clinical diagnosis of Spinocerebellar ataxia No history of epilepsy No other neuromuscular disorder No fracture within the last six months and restricted movement on the upper extremity Limited trembling hand allowed for the EMG recording.

Ages Eligible for Study
-----------------
Minimum Age: 20 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: The SCA<br> | Device: Neuromuscular electrical stimulation<br>* All groups received an accumulated 30-minute NMES (25 Hz, on/off: 800ms/800ms) intervention on median nerve.<br>|
| Experimental: The age-matched control<br> | Device: Neuromuscular electrical stimulation<br>* All groups received an accumulated 30-minute NMES (25 Hz, on/off: 800ms/800ms) intervention on median nerve.<br>|
| Experimental: The young control<br> | Device: Neuromuscular electrical stimulation<br>* All groups received an accumulated 30-minute NMES (25 Hz, on/off: 800ms/800ms) intervention on median nerve.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Central Motor Excitability | Measure of changes in Central Motor Excitability by motor evoked potential and silent period that are measured by transcranial magnetic stimulation. | Baseline, in experiment, 0 minute, 10 minutes, and 20 minutes. | 
| Peripheral Motor Excitability | Measure of changes in peripheral motor excitability by Maximum M wave and H reflex | Baseline, in experiment, 0 minute, 10 minutes, and 20 minutes. | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
spinocerebellar ataxia (SCA), motor evoked potential (MEP), Neuromuscular electrical stimulation (NMES), silent period, cerebellum