Neuroplastic Change in Myelin of the Brain (Myelin)

Structural and Functional Correlates of Neuroplastic Change Associated With Stroke

The main goal of this research is to advance understanding of how stroke changes both the structure and function of the brain. The investigators will determine which is the key driver of recovery of arm function after stroke: changes in the structure of the brain or changes in how brain regions interact with one another.

Study Overview

• Status: Unknown
• Conditions: Stroke
• Intervention / Treatment: Behavioral: TRAIT Task

Detailed Description

The main goal of this research is to advance understanding of how stroke changes both the structure and function of the brain. Further, the investigators will determine which is the key driver of recovery of arm function after stroke: changes in the structure of the brain or changes in how brain regions interact with one another. Together, these data will advance the investigators understanding of how neural systems support recovery from stroke. The investigators will use a MRI technique that allows us to assess the health of a brain structure called myelin. This structure is important as it allows information to travel down nerves faster; the more myelin the quicker the signal can be conducted. The investigators aim is to test whether or not movement training can restore myelin in the brain. If movement training does restore myelin in the brain, the investigators will have identified an important new target for rehabilitation interventions.

• Study Type: Interventional
• Enrollment (Anticipated): 88
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V6T 1Z3
      • Recruiting
      • University of British Columbia
      • Sub-Investigator: Alexander MacKay, PhD
      • Sub-Investigator: Michael Borich, PhD
      • Principal Investigator: Lara Boyd, PT; PhD
      • Sub-Investigator: Janice Eng, PhD
      • Sub-Investigator: Negar Asdaghi, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• individuals aged 40-75
• movement-related deficits associated with a middle cerebral artery stroke
• first time stroke affecting the corona radiata and/or internal capsule
• Fugl-Meyer upper extremity motor score of at least 15 but not greater than 55.

Exclusion Criteria:

• outside the age range of 40-75
• show signs of dementia (score < 24 on the Montreal Cognitive Assessment)
• have aphasia (score < 13 on the Frenchay Aphasia Screen)
• history of head trauma, a major psychiatric diagnosis, neurodegenerative disorder or substance abuse;
• taking any drugs (GABAergic, N-methyl-D-aspartate A-receptor (NMDA) antagonist) known to influence neuroplasticity;
• report contraindications to MRI (see supporting documents)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Stroke Group; Participants in the stroke group will complete 10 training sessions of the TRAIT task.	Behavioral: TRAIT Task; Increased paretic arm will be manipulated through the performance of a semi-immersive virtual reality-based intercept and release task called TRAIT (TRack And Intercept Task), which is performed in an interactive environment. TRAIT employs an open source Kinect sensor, which tracks 3-D joint movement. Participants are asked to control an on-screen icon using movements of their paretic arm to intercept a moving object as it emerges from the side of a computer screen. Once intercepted, they must accurately throw the object to hit a target. Participants move up through 10 levels of the game as their skill improves. Participants will complete 10 TRAIT training sessions in 4 weeks for a total of 10,000 experimental movements.
Active Comparator: Matched Healthy Control Group; Participants in the Matched Healthy Control group will complete 10 sessions of the TRAIT task	Behavioral: TRAIT Task; Increased paretic arm will be manipulated through the performance of a semi-immersive virtual reality-based intercept and release task called TRAIT (TRack And Intercept Task), which is performed in an interactive environment. TRAIT employs an open source Kinect sensor, which tracks 3-D joint movement. Participants are asked to control an on-screen icon using movements of their paretic arm to intercept a moving object as it emerges from the side of a computer screen. Once intercepted, they must accurately throw the object to hit a target. Participants move up through 10 levels of the game as their skill improves. Participants will complete 10 TRAIT training sessions in 4 weeks for a total of 10,000 experimental movements.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Myelin water fraction	Myelin water fraction (MWF) is the area of the short T2 component (15-35ms) divided by the total T2 distribution expressed as a percentage (MWF% = MWF*100)	Baseline and 30 days post baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Fractional anisotropy	Diffusion properties will be defined by calculating a 6-element tensor ellipsoid to provide both the magnitude and direction of diffusivity in a local orthogonal coordinate system within each voxel. Fractional anisotropy (FA) will be calculated to provide an index of microstructural white matter integrity.	Baseline and 30 days post baseline

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Hemiparetic arm use measured by accelerometry	Average daily movement counts indexed with accelerometers worn at the wrist	Baseline and 30 days post baseline

Collaborators and Investigators

• Sponsor: University of British Columbia
• Collaborators: Canadian Institutes of Health Research (CIHR)
• Investigators: Principal Investigator: Lara A Boyd, PT; PhD, University of British Columbia

Study record dates

Study Major Dates

• Study Start: September 1, 2014
• Primary Completion (Anticipated): September 1, 2017
• Study Completion (Anticipated): September 1, 2018

Study Registration Dates

• First Submitted: August 27, 2013
• First Submitted That Met QC Criteria: September 4, 2013
• First Posted (Estimate): September 10, 2013

Study Record Updates

• Last Update Posted (Estimate): January 10, 2017
• Last Update Submitted That Met QC Criteria: January 9, 2017
• Last Verified: January 1, 2017

More Information

Terms related to this study

• Keywords: myelin; neuroplastic change
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: H13-01952

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED