Noninvasive Brain Stimulation to Evaluate Neural Plasticity After Stroke

Emory University

Status: Terminated

Conditions: Cerebrovascular Stroke

Treatments: Device: Traditional Paired Associative Stimulation; Device: Median Nerve Stimulation; Device: Transcranial Magnetic Stimulation; Device: Corticocortical Paired Associative Stimulation; Device: Sham Paired Associative Stimulation

Study type: Interventional

Funder types: Other

Identifiers

NCT02465034

IRB00081268

Details and patient eligibility

About

The purpose of this study is to examine how different areas in the brain interact with each other and how using brain imaging and brain stimulation approaches can influence these interactions.

Full description

Subcortical strokes affect small vessels deep in the brain, and typically present with motor hemiparesis. The investigator will assess the effects of Transcranial Magnetic Stimulation (TMS) on motor function and examine how different areas in the human brain interact with each other using brain imaging and brain stimulation. The investigator will also evaluate the capacity for noninvasive stimulation to transiently modify brain activity supporting arm movement.

Enrollment: 45 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Age between 18-85 years
2. Middle cerebral artery stroke
3. Individuals with a first time stroke that affects the corona radiata and/or internal capsule

Exclusion criteria

1. Age outside the age range of 18-85 years
2. Signs of dementia (score < 24 on the Montreal Cognitive Assessment)
3. Aphasia (score < 13 on the Frenchay Aphasia Screen)
4. History of head trauma
5. History of a major psychiatric diagnosis
6. History of a neurodegenerative disorder
7. History of substance abuse
8. Contraindications to Transcranial Magnetic Stimulation

Trial design

Primary purpose: Basic Science

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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45 participants in 2 patient groups

Subcortical stroke

Active Comparator group

Description:

Subjects with subcortical stroke in the chronic phase of recovery with mild-moderate impairment of arm function will undergo noninvasive targeting of cortical locations by stereotactic neuronavigation using Transcranial Magnetic Stimulation (TMS), median nerve stimulation and arm motor function assessments. A paired associative stimulation (PAS) protocol using noninvasive stimulation will also be used which will be one of the following, a traditional or a corticocortical or a sham paired associative stimulation protocol. The subjects will also undergo median nerve stimulation.

Treatment:

Device: Sham Paired Associative Stimulation

Device: Traditional Paired Associative Stimulation

Device: Transcranial Magnetic Stimulation

Device: Median Nerve Stimulation

Device: Corticocortical Paired Associative Stimulation

Healthy Control

Active Comparator group

Description:

Healthy individuals will undergo noninvasive targeting of cortical locations by stereotactic neuronavigation using Transcranial Magnetic Stimulation (TMS), median nerve stimulation and arm motor function assessments. A paired associative stimulation (PAS) protocol using noninvasive stimulation will also be used which will be one of the following, a traditional or a corticocortical or a sham paired associative stimulation protocol.

Treatment:

Device: Sham Paired Associative Stimulation

Device: Traditional Paired Associative Stimulation

Device: Transcranial Magnetic Stimulation

Device: Median Nerve Stimulation

Device: Corticocortical Paired Associative Stimulation