Optimal Targeted High-definition Transcranial Direct Current Stimulation for Reducing Post-stroke Upper Limb Motor Impairments

May 26, 2026 updated by: Yuan Yang, Carle Foundation Hospital

Optimal Targeted High-definition tDCS for Reducing Post-stroke Upper Limb Motor Impairments

Non-invasive, non-pharmaceutical technologies that augment routine clinical practice for brain diseases and manage chronic symptoms have advanced rapidly over the past two decades. Among these, non-invasive brain stimulation such as transcranial direct current stimulation (tDCS) promotes neuroplasticity in injured brains, with fewer side effects and risks than invasive, implanted approaches such as deep-brain stimulation. Stimulating the brain can improve its function and help with recovery after a stroke. It has been a challenge to do this non-invasively. This is because the brain is reshaped after a stroke, and thus, it is difficult to find the right places to stimulate from the outside. In previous research, investigators found that optimal type and target of tDCS varied among subjects. The goal of this pilot trial is to test the feasibility of combining individually optimized, targeted high-definition tDCS (THD-tDCS) with rehabilitation therapy. Investigators will include 16 chronic stroke subjects with their optimal stimulation setup, obtained from their previous research. The participants will be computer-randomized into two equal-sized groups to receive either optimal THD-tDCS or sham stimulation, together with rehabilitation therapy (modified constraint-induced movement therapy, mCIMT) for five sessions over two weeks. Outcome measures will be collected at the baseline and right after the final intervention session. The primary outcome measure will be the change in the FM-UE score from baseline to immediately post the final intervention to assess the immediate effect of the intervention on upper extremity motor impairment. The secondary outcome measure will be the Wolf Motor Function Test time score to evaluate the immediate effect on functional motor performance.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

16

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 Contact Backup

Study Locations

  • United States
    • Illinois
      • Urbana, Illinois, United States, 61801-3028
        • Carle Foundation Hospital
        • Principal Investigator:
          • Yuan Yang, PhD, MS
        • Contact:
        • Sub-Investigator:
          • Sanjiv Jain, MD

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

No

Description

Inclusion Criteria:

  • Must be 18 years or older
  • Must have had a stroke that resulted in paresis confined to one side. The use of a wheelchair or other assisting devices are not exclusionary.
  • Must have substantial motor impairment of the paretic upper limb
  • Absence of severe wasting or contracture or significant sensory deficits in the paretic upper limb
  • Absence of severe concurrent medical problems (e.g. cardiorespiratory impairment)
  • Fugl-Meyer Upper Extremity Score of 8-50 based on assessment performed during the baseline visit.
  • Must have had either MRI or CT of the brain performed at Carle as part of their stroke care. Imaging may have been performed either during the diagnostic work-up for stroke or as follow-up after diagnosis. The most recent images from either MRI or CT will be collected for this study.
  • Capacity to provide informed consent and participate in English (Since this study is a clinical trial and the team is yet to provide the translation service at this stage, the study is restricted to those who can consent and participate in English only).
  • Must be willing and able to perform study procedures

Exclusion Criteria:

  • Self-reported sensitive skin or adhesive allergy as assessed by the tDCS Safety Screening Questionnaire
  • Has a cardiac pacemaker, defibrillator or an implantable cardiac resynchronization therapy device
  • Has metal implants in the head and/or brain
  • Presence of muscle tone abnormalities and motor or sensory impairment in the non-paretic limb
  • Presence of severe muscle wasting or contracture or significant sensory deficits in the paretic upper limb
  • Currently pregnant or planning to become pregnant during the study period
  • History of epilepsy, febrile convulsion, recurrent fainting spells or unexplained recurring headaches
  • Current use of illicit/recreational drugs
  • Currently undergoing anti-malarial treatment. (Note: participants can be considered for study participation after ant-malarial treatment has been discontinued)
  • Has known adverse reaction to TMS or tDCS

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: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Optimal targeted HD-tDCS + mCIMT
Optimal targeted HD-tDCS (high-definition transcranial direct current stimulation) during Constraint Induced Movement Therapy (mCIMT)
Device: High-definition transcranial direct stimulation: optimal
High-definition transcranial direct stimulation with individualized, optimal parameters.
Behavioral: Modified constraint-induced movement therapy
Modified Constraint-Induced Movement Therapy (mCIMT) is an evidence-based neurorehabilitation approach that improves upper limb function after stroke or brain injury by restricting the unaffected limb while intensively training the affected limb.
Sham Comparator: Sham HD-tDCS + mCIMT
Sham HD-tDCS (high-definition transcranial direct current stimulation) administers no dose or zero milliampere stimulation through the tDCS device, during Constraint Induced Movement Therapy (mCIMT)
Behavioral: Modified constraint-induced movement therapy
Modified Constraint-Induced Movement Therapy (mCIMT) is an evidence-based neurorehabilitation approach that improves upper limb function after stroke or brain injury by restricting the unaffected limb while intensively training the affected limb.
Device: High-definition transcranial direct stimulation: sham
High-definition transcranial direct stimulation with zero stimulation intensity (placebo)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in the Fugl-Meyer Upper Extremity score from baseline
Time Frame: Right after the final intervention session
Fugl-Meyer Upper Extremity (FM-UE) is a measure of motor impairment (0 to 66 points, with higher points indicating less impairment). FM-UE scale consists of a 33-item assessment which provides a global assessment of upper extremity motor impairment. A rater provides an ordinal rating (2=near normal ability/response, 1=partial ability, 0=unable to perform/no response) for each item.
Right after the final intervention session

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in the Wolf Motor Function Test Time Score From Baseline
Time Frame: Right after the final intervention session
Wolf Motor Function (WMFT) Test is a measure of functional motor activity that quantifies upper extremity motor ability through timed and functional tasks. The WMFT Time Score the median of 15 timed arm movements and hand dexterity tasks, each to be completed up to 120s. If a task could not be completed in 120s, a score of 121s was assigned. Higher score indicates a worse motor function.
Right after the final intervention session

Collaborators and Investigators

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

Sponsor

Carle Foundation Hospital

Collaborators

American Heart Association

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)

July 1, 2026

Primary Completion (Estimated)

March 31, 2027

Study Completion (Estimated)

June 30, 2027

Study Registration Dates

First Submitted

May 14, 2026

First Submitted That Met QC Criteria

May 14, 2026

First Posted (Actual)

May 20, 2026

Study Record Updates

Last Update Posted (Actual)

May 28, 2026

Last Update Submitted That Met QC Criteria

May 26, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 26CNI4419
  • 26BCDA1622682 (Other Grant/Funding Number: American Heart Association)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

I will follow American Heart Association Open Science Policy to share IPD: https://professional.heart.org/en/research-programs/awardee-resources/open-science-policy-statements-for-aha-funded-research

IPD Sharing Time Frame

Please refer to https://professional.heart.org/en/research-programs/awardee-resources/open-science-policy-statements-for-aha-funded-research for detailed information in term of time-frame of sharing such data

IPD Sharing Access Criteria

Please refer to https://professional.heart.org/en/research-programs/awardee-resources/open-science-policy-statements-for-aha-funded-research for detailed information in term of access criteria

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

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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