Taking peopleNo phase

Studying how a startling sound affects movement in spinal cord injury

Uses startling sounds to study movement after spinal cord injury.

Key facts

Who runs it: University of Zurich
Where: Switzerland1 site in 1 countryChoose a country to see its sites
Trial code: NCT04967274
Registry title: Reticulospinal Control of Movements
Status: Recruiting
People taking part: 248 people, planned
Started: 15 Jan 2022
Expected to end: 31 Dec 2027
Type of study: Interventional
Treatments tested: Startling acoustic stimulus
Record updated: 5 November 2026

Who can take part

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for healthy adults and adults with a spinal cord injury. It studies how a brainstem movement pathway controls movement and recovery, using sudden loud sounds.

Age: 18 Years to 80 Years
Sex: All sexes can join.
Disease stage: For people with spinal cord injury: ASIA Impairment scale (AIS) A-D. The damage must be in the neck (C4-C7) or mid-back (T4-T12). Both recent (acute) and long-standing (chronic) injuries are studied.
Biomarker or test result: For neck injuries: nerve tests must show both ulnar nerves are intact. For mid-back injuries: nerve tests must show both tibial and peroneal nerves are intact.

Main reasons for not taking part

Pregnant or breastfeeding women
Other current nerve or brain problems besides the spinal cord injury, or bone and joint problems affecting arm or leg movement
Past alcohol abuse or use of drugs that affect the mind
Past major heart or lung disease
Current major depression, psychosis, or fever of unknown cause

The registry criteria, word for word

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Who can take part

Written informed consent as documented by signature; For SCI patients:
ASIA Impairment scale (AIS) A-D
Focal damage at cervical (C4-C7; i.e. damage rostral of the spi-nal segments innervating the examined hand and leg muscles) or thoracic (T4-T12; i.e. damage caudal of the spinal segments innervating the m. abductor digiti minimi, but rostral of the spi-nal segments innervating the m. tibialis anterior)
Patients with cervical SCI must reveal bilaterally intact ulnar nerves as demonstrated by normal compound motor action potential (cMAP), nerve conduction velocity (NCV) and F-wave latencies in clinical neurography
Patients with thoracic SCI must reveal bilaterally intact tibial and peroneal nerves as demonstrated by normal cMAP, NCV and F-wave latencies

Who cannot take part

History of alcohol abuse or the intake of psychotropic drugs
History of major cardiac condition (e.g., infarction, insufficiency (NYHA II-IV))
History of major pulmonary condition (e.g., chronic obstructive pulmonary disease (GOLD II-IV))
Women who are pregnant or breast feeding
Current neurological problems other than SCI and related impairments
Current orthopaedic problems affecting upper and lower extremity movements
Current major depression or psychosis
Fever of unknown origin

Check if you might fit

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

Are you between 18 and 80 years old?

This trial has no sites in United States.

It has sites in one country. Choose a country to see its sites.

About the trial

What the trial wants to find out

Accurate movement execution is a result of a complex interplay between various muscle groups whose activity is controlled by different areas of the central nervous system. Besides the corticospinal system, the phylogenetically old reticulospinal system is a key motor system controlling different elementary movements including posture, locomotion and reaching across all mammals. In contrast to the extensively investigated corticospinal system, there is only sparse knowledge on the motor physiology of the functionally important reticulospinal system in humans. Reticulospinal motor control can be assessed with the StartReact paradigm which is based on the activation of reticulospinal motor circuitries by startling acoustic stimuli. The StartReact phenomenon is characterized by a shortening in movement reaction time which is mediated by a startle-triggered, early release of a planned motor program by the reticulospinal system. Thus, StartReact is a unique tool to examine reticulospinal involvement on human motor control under physiological and pathological conditions. StartReact assessments will be supplemented by comprehensive 3-D kinematic analysis and muscle activity recordings (i.e. electromyography) to gain quantitative insights into reticulospinal movement control.

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The first objective of this clinical study is to gain more insights into the mechanisms underlying StartReact and to advance the knowledge on reticulo-spinal motor physiology regarding different movement tasks (i.e. simple single-joint movements, complex multi-joint movements and bilateral hand movements) in healthy subjects. The findings of these experiments will provide new insights into proximal-distal, flexor-extensor and upper-lower extremity gradients in reticulospinal motor control of healthy subjects. Moreover, the results will expand the StartReact paradigm to complex, functionally more relevant movements (i.e. reaching and stepping tasks requiring endpoint accuracy; co-operative, bilateral hand movements) for which the involvement of the reticulo-spinal system is not yet understood.

The second goal of this project is to use the StartReact paradigm to shed more light onto the role of reticulospinal plasticity in functional recovery of patients with spinal cord injury (SCI). Whereas preclinical findings emphasize a remarkable potential of the reticulospinal system for neuroplastic adaptations underlying functional recovery, there is only little evidence from clinical trials in the field of SCI. First, the study aims at monitoring StartReact effects in hand and leg muscles of patients with acute SCI over a period of 6 months. Simultaneous tracking of StartReact effects and motor recovery will allow to closely relate processes of reticulospinal plasticity to functional recovery in patients with acute SCI. Second, the focus will be on the re-weighting of descending motor control (i.e. cortico- vs. reticulospinal system) in response to SCI and investigate the distinct contributions of the cortico- and reticulospinal system to motor recovery in patients with chronic SCI.

The findings of this project will advance the mechanistic understanding on the motor physiology and neurorestorative capacity of the reticulospinal system in humans. New insights from these projects will hopefully translate into a better exploitation of this important motor system in clinical trials that aim to improve motor recovery in patients with SCI.