The Use of Dual-coil Transcranial Magnetic Stimulation to Measure and Modulate Poststroke Interhemispheric Inhibition.

February 19, 2026 updated by: The Hong Kong Polytechnic University

Using Dual-coil Transcranial Magnetic Stimulation to Measure and Modulate Poststroke Interhemispheric Inhibition (IHI): A Concurrent TMS-EEG-EMG Study

Objectives: This project will (1) establish the test-retest reliability of a novel transcranial magnetic stimulation-electroencephalography (TMS-EEG) interhemispheric inhibition (IHI) measure and (2) validate it against the TMS-EMG-based IHI measure (the gold standard). It will also (3) compare effects of dual-coil cortico-cortical paired associative stimulation (ccPAS) protocols with different interstimulus intervals (ISI) on this TMS-EEG-based IHI marker in poststroke patients. Methods: Study 1: IHI will be conducted in 20 stroke patients and 20 healthy counterparts using TMS-EEG and TMS-EMG; furthermore, both measures will be repeated after one week for test-retest reliability. Study 2: A randomized-crossover trial where 20 stroke patients undergo a single-session ccPAS in three separate visits (ISI: 8ms: LTD-like, 12ms: LTP-like, 100ms: sham) to investigate the differential modulatory effects in IHI.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Objectives: This project will (1) establish the test-retest reliability of a novel transcranial magnetic stimulation-electroencephalography (TMS-EEG) interhemispheric inhibition (IHI) measure and (2) validate it against the TMS-EMG-based IHI measure (the gold standard). It will also (3) compare effects of dual-coil cortico-cortical paired associative stimulation (ccPAS) protocols with different interstimulus intervals (ISI) on this TMS-EEG-based IHI marker in poststroke patients. Methods: Study 1: IHI will be conducted in 20 stroke patients and 20 healthy counterparts using TMS-EEG and TMS-EMG; furthermore, both measures will be repeated after one week for test-retest reliability. Study 2: A randomized-crossover trial where 20 stroke patients undergo a single-session ccPAS in three separate visits (ISI: 8ms: LTD-like, 12ms: LTP-like, 100ms: sham) to investigate the differential modulatory effects in IHI.

Study Type

Interventional

Enrollment (Estimated)

20

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • (1) have a diagnosis of ischemic or hemorrhagic stroke, with time after stroke onset≥6 months. For stroke patients, we will invite participants to receive a structural magnetic resonance imaging (MRI) at the University Research Facility in Behavioral and Systems Neuroscience to verify their actual lesion location; (2) aged between 18 and 80 years old; (3) with residual upper limb functions from 4-7 levels in the Functional Test for the Hemiplegic Upper Extremity (Hong Kong version); (4) have evocable MEP from both M1; (5) able to give informed written consent to participate in the study. (6) able to understand and communicate with Chinese.

Exclusion Criteria:

(1) any contraindications to TMS (screened by the safety checklist by Rossi); (2) any concomitant neurological disease; (3) any sign of moderate-to-severe cognitive problems, i.e., the abbreviated mental test Hong Kong version<6 out of 10 points [22]; and (4) Modified Ashworth score>2 in hand, wrist or elbow extensor muscle in their hemiparetic upper limbs.

In addition, a group of age-matched, right-hand-dominant healthy adults, without any known neurological and psychiatric diseases, will be enrolled.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: ccPAS (8ms)
ccPAS session will involve 180 paired pulses repeated at a frequency of 0.2Hz (approximately 15 minutes), stimulating the ipsilesional M1 8ms after the first pulse over the contralesional M1.
Device: Dual coil transcranial magnetic stimulation
The ccPAS will be applied using a MagPro X100/R30 stimulator and a MagPro R20/R30 extension connected to two vertically oriented figure-of-eight coils designed for bilateral hemispheric stimulation.
Experimental: ccPAS (12ms)
ccPAS session will involve 180 paired pulses repeated at a frequency of 0.2Hz (approximately 15 minutes), stimulating the ipsilesional M1 12ms after the first pulse over the contralesional M1.
Device: Dual coil transcranial magnetic stimulation
The ccPAS will be applied using a MagPro X100/R30 stimulator and a MagPro R20/R30 extension connected to two vertically oriented figure-of-eight coils designed for bilateral hemispheric stimulation.
Sham Comparator: Sham ccPAS
ccPAS session will involve 180 paired pulses repeated at a frequency of 0.2Hz (approximately 15 minutes), stimulating the ipsilesional M1 100ms after the first pulse over the contralesional M1.
Device: Dual coil transcranial magnetic stimulation
The ccPAS will be applied using a MagPro X100/R30 stimulator and a MagPro R20/R30 extension connected to two vertically oriented figure-of-eight coils designed for bilateral hemispheric stimulation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
transcranial magnetic stimulation-evoked potential in electroencephalography (TMS-EEG)
Time Frame: Baseline
The amplitude of P30 (28-35ms) will be extracted from the artifact-free TEP trials to represent the cortical excitatory activity.
Baseline
Transcranial magnetic stimulation-evoked potential in electroencephalography
Time Frame: After stimulation (15 mins post)
The amplitude of P30 (28-35ms) will be extracted from the artifact-free TEP trials to represent the cortical excitatory activity.
After stimulation (15 mins post)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

The Hong Kong Polytechnic University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

March 15, 2026

Primary Completion (Estimated)

December 31, 2028

Study Completion (Estimated)

June 1, 2029

Study Registration Dates

First Submitted

February 19, 2026

First Submitted That Met QC Criteria

February 19, 2026

First Posted (Actual)

February 25, 2026

Study Record Updates

Last Update Posted (Actual)

February 25, 2026

Last Update Submitted That Met QC Criteria

February 19, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • HSEARS20251026002

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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