Cryoneurolysis for Spasticity

SP
FM
Overseen ByFraser MacRae, BSc
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new technique called cryoneurolysis to assist individuals experiencing muscle stiffness (spasticity) after a stroke. Cryoneurolysis uses a freezing technique to break down specific nerves, potentially relieving muscle stiffness and improving movement. Researchers aim to assess how this treatment affects brain function over six months. They employ methods like magnetic pulses and brain imaging to study these changes. Ideal participants have had a stroke, can understand English, and have experienced relief from a test nerve block. As an unphased trial, this study offers participants the chance to contribute to groundbreaking research that could lead to new treatments for stroke-related spasticity.

Will I have to stop taking my current medications?

Yes, you will need to stop taking any antispastic medications during the follow-up period of the trial.

What prior data suggests that this technique is safe for treating spasticity?

Research has shown that cryoneurolysis has been safely used for many years, particularly for pain management. Studies indicate it is a promising treatment for muscle stiffness (spasticity) with generally manageable side effects. Most people do not experience pain or numbness for more than three months after treatment, suggesting it is usually well-tolerated. Cryoneurolysis is approved for use in Canada, indicating a good safety record. However, it is important to note that while not yet a standard treatment for spasticity, research continues to explore its long-term effects.12345

Why are researchers excited about this trial?

Unlike the standard treatments for spasticity, which often include medications like baclofen or physical therapies, cryoneurolysis offers a novel approach by applying extreme cold directly to targeted nerves. This technique induces a process called Wallerian degeneration, where the nerve's axon is destroyed, stopping it from sending signals, but allows the nerve to regenerate naturally over time. Researchers are excited about cryoneurolysis because it targets the nerves directly and may provide longer-lasting relief without the need for continuous medication, potentially reducing side effects associated with systemic drug treatments.

What evidence suggests that cryoneurolysis is effective for treating spasticity?

Research has shown that cryoneurolysis, the treatment under study in this trial, can help reduce spasticity, a condition where muscles become too tight and hard to move. In several studies, patients who received cryoneurolysis experienced significant benefits, such as easier limb movement and reduced pain. For instance, one study found that 13 out of 16 patients reported less muscle tightness for at least six months. Another study demonstrated that cryoneurolysis provided lasting relief from spasticity and improved limb movement for up to a year. These findings suggest that cryoneurolysis may help people with spasticity move more freely and with less discomfort.26789

Who Is on the Research Team?

SP

Sue Peters, PhD

Principal Investigator

Western University

Are You a Good Fit for This Trial?

This trial is for individuals with spasticity, a condition that can interfere with daily activities. Participants should have had a stroke and be eligible for cryoneurolysis treatment in Canada. The study involves six visits over six months to specific hospitals.

Inclusion Criteria

Can understand and follow instructions in English
I can slightly move my arms or hands.
Patient at Parkwood Institute
See 4 more

Exclusion Criteria

Have contraindications to TMS (i.e., history of seizure, pregnancy) or 3T MRI (i.e., certain metallic implants)
I am able to understand and agree to the study's requirements.
I am taking medication for muscle spasms during the study.
See 2 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Treatment

Participants receive cryoneurolysis treatment, involving the application of extreme cold to targeted nerves under ultrasound guidance

1 day
1 visit (in-person)

Follow-up

Participants are monitored for changes in spasticity severity and brain function using TMS, MRI, and fNIRS

6 months
5 visits (in-person) at Parkwood Institute, 1 visit (in-person) at St. Joseph's Hospital

Long-term Monitoring

Participants' health-related quality of life, range of motion, and grip strength are assessed over time

6 months

What Are the Treatments Tested in This Trial?

Interventions

  • Cryoneurolysis
Trial Overview The trial tests the long-term effects of cryoneurolysis on brain function in people with spasticity. It uses techniques like transcranial magnetic stimulation (TMS), MRI, and functional near-infrared spectroscopy (fNIRS) to assess changes in the central nervous system.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: InterventionExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Sue Peters

Lead Sponsor

Pacira Pharmaceuticals, Inc

Industry Sponsor

Trials
142
Recruited
14,300+
Headquarters
Tampa, USA
Known For
Non-opioid Pain Management
Top Products
Exparel, Zilretta, iovera
Dr. Jonathan Slonin profile image

Dr. Jonathan Slonin

Pacira Pharmaceuticals, Inc

Chief Medical Officer since 2020

BSc in Biomedical Engineering and MD from University of Miami, MBA from George Washington University

Frank D. Lee

Pacira Pharmaceuticals, Inc

Chief Executive Officer since 2024

BSc in Chemical Engineering from Vanderbilt University, MBA from Wharton Graduate School of Business

Published Research Related to This Trial

In a study involving 113 patients undergoing ultrasound-guided percutaneous cryoneurolysis for spasticity, 96.75% of nerve treatments resulted in no significant pain or dysesthesias beyond the treatment period, indicating a high safety profile.
While a few patients experienced temporary nerve pain or numbness, most adverse effects were manageable and resolved within three months, suggesting that cryoneurolysis could be a safe and effective treatment option for spasticity.
Analysis of Adverse Effects of Cryoneurolysis for the Treatment of Spasticity.Winston, P., MacRae, F., Rajapakshe, S., et al.[2023]

Citations

Cryoneurolysis for Spasticity Treatment: Long-term ...13-18 The investigators have published data showing the effectiveness of cryoneurolysis on spasticity affecting the upper and lower limbs.
A Novel Treatment for Management of Spasticity. Presentation ...Results were variable but show modest improvements in a majority of the cases. The MAS was reduced for at least 6 months in 13 of 16 spastic ...
Case Report Cryoneurolysis for Managing Spasticity in ...Cryoneurolysis was found to lead to an increased range of motion (ROM), reduced spasticity, and reduced pain of targeted joints in patients with upper limb ...
Measuring the Efficacy of Percutaneous Cryoneurolysis in...Cryoneurolysis can provide long-lasting improvements in upper limb spasticity, function, and pain, as well as participant satisfaction for up to 1 yr for ...
Percutaneous Cryoneurolysis as a Dynamic Treatment for ...All 10 patients experienced immediate improvements that were sustained for 1-12 months after treatment. Cryoneurolysis is a safe and effective ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/37104641/
Analysis of Adverse Effects of Cryoneurolysis for the ...Few had pain or numbness beyond 3 mos. Cryoneurolysis has potential to be a safe spasticity treatment with manageable adverse effects.
Percutaneous Cryoneurolysis as a Dynamic Treatment for ...Cryoneurolysis is a safe and effective treatment for spasticity and can allow for easy access to involved nerves.
Measuring the Efficacy of Percutaneous Cryoneurolysis in ...Electronic Data Capture). Safety data were previously published as part of 3 ongoing studies of cryoneurolysis for spasticity.13. Statistical ...
Cryoneurolysis: A Novel Treatment for Management of ...Assurance about the safety of cryoneurolysis can be drawn from over 40 years of its use in the management of pain. In addition, several ...
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