Syringomyelia

Amyotrophic lateral sclerosis ALS is a severe and rapidly progressing nervous system disease with an average survival of two to three years after diagnosis. Patients experience significant physical and psychological challenges, and apart from the drug Riluzole, effective treatments are lacking. This study aims to understand how life-sustaining ventilation support, either non-invasive or with tracheostomy, impacts the quality of life of ALS patients, their partners, and children, addressing a difficult ethical issue in ALS care. Participants are divided into two groups those who choose life-prolonging treatment with long-term mechanical ventilation support and those who decline such treatment. The study involves a longitudinal questionnaire approach conducted in Norway, measuring overall, health-related, and disease-specific quality of life over time. Assessments occur at inclusion and then every three months up to 21 months. Throughout the study, ALS patients, their partners, and children complete various quality of life questionnaires, including the Quality of Life Scale, EQ-5D-5L, ALS-specific scales, and caregiver burden surveys. Researchers monitor changes in these assessments to understand the effects of ventilation support. The study is sponsored by Haukeland University Hospital and includes participants aged 8 years and older, with data collection planned until 2032.

Researchers are evaluating the potential benefits of repetitive transcranial magnetic stimulation rTMS on motor function recovery in adults with spinal cord injuries. This study focuses on patients with incomplete cervical or thoracic spinal cord injury classified as ASIA C or D. The goal is to assess whether non-invasive stimulation of the primary motor cortex can improve motor functions and support future development of new treatments. Participants will be randomly assigned to one of two groups one receiving active intermittent theta burst stimulation delivered by a figure-of-eight coil targeting the leg area of the primary motor cortex at 90% motor threshold, and the other receiving placebo stimulation with a coil that produces skin tingling but no brain stimulation. The treatment consists of 15 stimulation sessions over three weeks. During the 12-week follow-up period, participants will undergo various electrophysiological and functional tests to assess motor functions of upper and lower limbs, including motor evoked potentials, spasticity measurements, the Nine-Hole Peg Test, and the 10-meter walking test. Pain levels and self-reported autonomic functions will also be evaluated. This monitoring aims to measure the treatments impact and safety throughout the study duration.

This research aims to establish the feasibility and detailed parameters of Magnetic Resonance Spectroscopy MRS for assessing spinal cord lesions in adults. The study focuses on mapping the total spine spectrum at short echo times to facilitate future comparisons for evaluating the malignant potential and grading of spinal cord lesions. Additionally, it will explore the reproducibility of the MRS protocol and investigate the effects of radiation on the spinal cord over different time frames in patients receiving craniospinal irradiation CSI. Participants include both healthy volunteers and patients with low volume leptomeningeal disease LMD undergoing standard CSI treatment. The study involves performing MRS scans on the spine to gather data on the spinal cord spectrum. This protocol will be applied to volunteers and patients to test its applicability and reproducibility. The study will collect data during and after radiation therapy to assess changes and support future trials focused on functional status and tumor grading. Participants will undergo MRS spine scans as the main study procedure. Researchers will monitor safety and any adverse events throughout the study period, which is expected to last up to one year. The study collects imaging data to evaluate spinal cord lesions and radiation effects while ensuring participant consent and ability to comply with procedures. This observational period will help establish MRS as a potential diagnostic tool for spinal cord assessment.

Researchers are evaluating whether surgical release of the filum terminale, a fibrous tissue at the end of the spinal cord, provides better symptom relief than medical management in patients with Occult Tethered Cord Syndrome OTCS. This phase II pilot randomized-controlled trial aims to assess the preliminary effectiveness and safety of surgery compared to medical treatment for this condition. Participants will be randomly assigned to either undergo surgical untethering of the filum terminale or receive only medical management. Symptom improvement and any adverse events will be monitored and recorded for one year after treatment begins. After at least one year, patients initially receiving medical management may switch to surgery if the principal investigator considers it beneficial. Throughout the study, participants will have their symptoms evaluated using the OCCULT Scale at the start and after one year. Additional assessments include urologic and fecal incontinence scores, medication changes, and intra-operative findings during surgery. Safety and symptom changes will be carefully tracked for one year to understand the treatment effects and risks involved.

Researchers are studying a surgical technique called fetoscopy to correct fetal myelomeningocele, a form of spina bifida, before birth. This pilot study compares two surgical approaches a percutaneous method offered to patients with a posterior placenta, and a laparotomy with uterine exteriorization method available to all participants regardless of placental location. The goal is to see if these techniques can successfully close the myelomeningocele defect before delivery. Participants will receive fetoscopic repair of the myelomeningocele using one of the two surgical approaches based on their placental position and preference. Those with an anterior placenta will undergo the laparotomy method, while those with a posterior placenta may choose either the percutaneous or laparotomy approach. The study evaluates the success rate of these in-utero surgeries from the time of operation until delivery, lasting up to 21 weeks. During the study, participants will undergo MRI and ultrasound to confirm lesion and hindbrain herniation levels. Social work and pediatric neurology consultations will assess eligibility and support. Participants must remain near the medical center for pregnancy and delivery and return for follow-up visits at 12, 24, 30, 48, and 60 months after birth. The study tracks surgical outcomes and monitors safety and development over time.

Researchers are evaluating a combination of spinal interstitial laser ablation and stereotactic spine radiosurgery SSRS to treat spinal tumors near the spinal cord, especially in patients with spinal metastasis that includes an epidural component. The study aims to improve tumor control, pain relief, preserve function, and enhance quality of life while documenting safety and accuracy of MRI-compatible hardware used for image guidance. This research measures how effective these combined treatments are compared to historical controls using SSRS alone. Participants will receive laser interstitial thermal ablation and CT-guided stereotactic radiosurgery, delivered via intensity-modulated radiation therapy, on separate days within a one to fourteen day window. The order of treatments is decided by the treating physician. Surgery occurs in an intraoperative suite equipped with an operating room and MRI scanner to guide the laser ablation precisely. During the study, participants will have regular assessments including MRI scans to monitor tumor control and epidural tumor regression at multiple time points up to 24 months. Researchers will also evaluate overall survival, muscle strength, pain levels, sensory and neurological function, ability to walk, and quality of life using validated tools. Adverse events will be tracked and correlated with imaging and symptom changes. The study involves ongoing follow-up visits for up to two years after treatment to measure outcomes and safety.

This research aims to evaluate a combined rehabilitation approach using testosterone replacement therapy TRT with locomotor training LT in men who have testosterone deficiency and walking difficulties after incomplete or complete spinal cord injury SCI. The study explores whether this combination can improve muscle size, bone mineral density, muscle function, and walking recovery in this group. It is a Phase 2 pilot study focused on men with low testosterone and ambulatory dysfunction following SCI. Participants will be divided into three groups one receiving weekly testosterone enanthate injections 100 mg, another receiving the same testosterone injections plus locomotor training involving treadmill and overground walking sessions four times per week for 2-3 months, and a non-treatment control group receiving no intervention. TRT will be administered for six months, with locomotor training occurring during the first 2-3 months alongside TRT in the combination group. During the study, participants will undergo assessments at baseline and at 1, 3, and 6 months, including MRI scans, DEXA scans to measure bone density, muscle performance tests, and walking ability evaluations such as the 6-minute walk test and 10-meter walk test. Safety evaluations will include physical exams, ECG, prostate exams, and blood tests monitoring hematocrit, liver enzymes, prostate-specific antigen, and other health markers. The study will compare outcomes among the three groups over six months to assess changes in muscle size, bone density, muscle strength, and walking function.

This research aims to improve manual wheelchair use for people with spinal cord diseases or injuries by studying a new ergonomic wheelchair design. Many manual wheelchair users experience shoulder pain from overuse, which can reduce their independence. The study focuses on a wheelchair that positions the hand rims better and offers different gearing options to ease propulsion and potentially reduce shoulder strain. The study has two parts. First, participants will use a single-speed ergonomic wheelchair to test three different gear ratios low 32, normal 11, and high 23. Next, participants will try a newly developed multi-speed ergonomic wheelchair featuring two hand rims per side, allowing users to shift gears simply by choosing which rim to push. These tests will help evaluate propulsion efficiency on various terrains and situations. Participants will complete several tests measuring wheelchair propulsion efficiency, energy use, and mobility performance, including 20 Meter Push Tests on different surfaces, 6 Minute Push Tests, and mobility-related activities. Feedback from users will guide wheelchair design improvements. The study involves up to four weeks of participation, with various assessments to measure work done, energy expenditure, and user experience with the wheelchairs.

Researchers are evaluating outcomes and their predictors in various neurosurgical conditions to improve the quality and consistency of research and clinical care. The study focuses on standardizing the assessment of clinical, cognitive, and psychological status before and after neurosurgical interventions across multiple centers. This effort aims to create a common language in routine practice and support better therapeutic decisions through shared data and identified predictive factors. The study collects detailed clinical and demographic information from patients undergoing neurosurgery for a wide range of conditions, including tumors, vascular diseases, trauma, spinal disorders, functional pathologies, peripheral nerve issues, and malformations. Data such as comorbidities, anesthesia details, complications, and psychological assessments are gathered before surgery and at follow-ups, with timing varying by condition. An artificial intelligence analysis will be used to identify important predictors and outcomes. Participants will provide data over a period of up to five years, including sociodemographic details, clinical status, cognitive and psychological assessments, and complication records. The study monitors these factors preoperatively and postoperatively to describe outcomes and explore associations with preoperative indicators. The long-term collection of data supports understanding neurosurgical results and guiding patient care more precisely.

Researchers are evaluating the safety, tolerability, and pharmacokinetics of NG004, a human monoclonal antibody administered intrathecally, in patients with acute incomplete cervical spinal cord injury SCI. This first-in-human, multicenter, open-label trial aims to determine the maximum tolerated dose of NG004 through multiple ascending doses. The study focuses on individuals with acute cervical SCI classified as ASIA impairment scale C-D, within 4 to 28 days after injury. Participants will receive repeated intrathecal injections of NG004 across four different dose regimens. The trial does not include a placebo group and involves sequential dosing to assess safety and drug behavior in the body. Treatment monitoring will continue up to 6 months after the last injection to measure drug levels and half-life. Throughout the study, participants will be closely observed for adverse events, serious adverse events, and reactions related to NG004 starting from treatment initiation up to 6 months. Blood samples will be taken at specific times after injections to analyze drug concentration and how long it stays in the bloodstream. The trial will include patients aged 18 to 70 years who are hemodynamically stable and do not require full mechanical ventilation. The total study duration for each participant extends through the treatment and follow-up periods.