Comparing the Location of the Motor Cortex in Children Using Two Methods

University of Minnesota (UMN)

Status: Completed

Conditions: Congenital Hemiparesis

Study type: Observational

Funder types: Other

Identifiers

NCT02015338

1311M45303

Details and patient eligibility

About

Hypothesis: In typically developing children (TDC), use of conventional EEG landmarks to determine the brain area that controls hand function will not differ from TMS-guided determination of individual motor hotspots. In children with hemiparesis, however, those two locations will diverge. The prediction is that TMS will best guide Transcranial Direct Current Stimulation (tDCS) interventions

Full description

Congenital hemiparesis, mainly due to stroke, affects approximately 25% of children with cerebral palsy. Noninvasive brain stimulation has emerged to influence improvements in hand function specifically in children with congenital hemiparesis due to stroke.

The use of one type of noninvasive brain stimulation, Transcranial Direct Current Stimulation (tDCS), in conjunction with rehabilitation training intervention for a child with hemiparesis proposes a synergistic approach to improving hand function. Application of electrodes over certain targeted areas are placed with the intent to stimulate and influence neuronal activity.

Our preliminary evidence suggests that in children with hemiparesis due to stroke, the area for placement is variable as noted by electroencephalogram (EEG) and Transcranial Magnetic Stimulation (TMS) measurement methods, influencing the site location of optimal stimulation for tDCS.

Due to this variation, the optimal site of stimulation warrants investigation for the optimal placement of tDCS.

Enrollment: 47 patients

Sex: All

Ages: 8 to 17 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

Typically Developing Children:

• Ages 8-17

Children with congenital hemiparesis due to hemispheric stroke:

• Ages 8-17
• Equal of greater than 10 degrees of active motion at the metacarpophalangeal joint
• No evidence of seizure activity within the last 2 years.

Exclusion criteria

Typically Developing Children:

• neurologic disorders
• indwelling metal
• pregnancy
• history of seizures

Children with hemiparesis:

• Metabolic disorders
• Neoplasm
• Epilepsy
• Disorders of cellular migration and proliferation
• Expressive aphasia
• Pregnancy
• Indwelling metal
• Botulinum toxin or phenol intramuscular block within the one-month preceding TMS application.

Trial design

47 participants in 2 patient groups

Typically Developing Children

Description:

Children with typical development (e.g. no presence of neurological disorders or diagnoses)

Children with Hemiparesis

Description:

Children diagnosed with Hemiparesis