Repetitive Transcranial Magnetic Stimulation on Motor Function and Meta-Plasticity in Cerebral Palsy: TMS-EEG Study
tiistai 12. toukokuuta 2026 päivittänyt: Cook Children's Health Care System
6-Hz Primed Low and High-Frequency Repetitive Transcranial Magnetic Stimulation on Motor Function and Meta-Plasticity in Children With Cerebral Palsy: TMS-EEG Study
This project examines the use of repetitive transcranial magnetic stimulation (rTMS) as a therapeutic approach to improve motor function in children with cerebral palsy (CP).
By applying 6-Hz primed low and high-frequency rTMS and measuring brain responses through TMS-EEG, the study aims to enhance neural plasticity and motor recovery.
The goal is to promote faster rehabilitation and reduce long-term healthcare needs.
Tutkimuksen yleiskatsaus
Tila
Ei vielä rekrytointia
Interventio / Hoito
Yksityiskohtainen kuvaus
Cerebral Palsy (CP) is a neurodevelopmental condition marked by motor impairments that affect both upper and lower limbs.
This project investigates the therapeutic benefits, safety, and tolerability of repetitive transcranial magnetic stimulation (rTMS) for improving motor function and meta-plasticity (re-organization) in children with CP.
Specifically, the study investigates the effects of 6-Hz primed low and high-frequency rTMS on neural motor function and meta-plasticity, utilizing TMS-EEG as a core method for assessing motor evoked potentials (MEPs) and TMS-evoked potentials (TEPs).
Through modulating cortical excitability, the investigators expect that 6-Hz primed low and high-frequency rTMS will improve motor function and generate meta-plasticity in children with CP.
This improvement in motor and induced meta-plasticity potentially leads to faster rehabilitation outcomes and reduced need for long-term care, which would benefit both patients and hospital systems by lowering treatment costs and improving resource allocation.
Opintotyyppi
Interventio
Ilmoittautuminen (Arvioitu)
60
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.
Opiskeluyhteys
- Nimi: Behnam Ghabel Damirchi, MSc
- Puhelinnumero: 682-367-3956
- Sähköposti: behnam.ghabeldamirchi@cookchildrens.org
Tutki yhteystietojen varmuuskopiointi
- Nimi: Christos Papadelis, PhD
- Puhelinnumero: 682-305-3236
- Sähköposti: Christos.Papadelis@cookchildrens.org
Opiskelupaikat
-
-
Texas
-
Fort Worth, Texas, Yhdysvallat, 76107
- Cook Children's Hospital
-
Ottaa yhteyttä:
- Dr. Christos Papadelis, PhD, PhD
- Puhelinnumero: 682-305-3236
- Sähköposti: Christos.Papadelis@cookchilrens.org
-
Alatutkija:
- Behnam G Ghabel Damirchi, MSc
-
-
Osallistumiskriteerit
Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Lapsi
- Aikuinen
Hyväksyy terveitä vapaaehtoisia
Joo
Kuvaus
Inclusion Criteria (CP):
- Aged 6 - 20 years,
- A confirmed diagnosis of CP by a specialized professional (pediatric neurologist, PM&R physician, neonatal developmental specialist, or neonatologist) is a prerequisite for participation,
- Classified as high functioning (Level I, II, or III) according to the Gross Motor Function Classification System (GMFCS),
- Age-appropriate ability to understand and comply with study procedure throughout the entire duration of the study,
- Preserved vision and hearing (with or without correction).
Inclusion Criteria (TD):
- Aged 6 - 20 years
- Age-appropriate ability to understand and comply with study procedure throughout the entire duration of the study,
- Preserved vision and hearing (with or without correction).
Exclusion Criteria (CP):
- Syndromic or genetic brain-related associations,
- History of major trauma or brain surgery,
- Inability to remain still,
- History of Epilepsy,
- Severe coexisting sickness or illness unrelated to CP or unstable medical conditions such as pneumonia,
- Modified Ashworth Scale: Shoulder, elbow, and wrist scores more than 3,
- Limb contractures caused by any other injury except CP,
- Severe movement disorders that prevent intentional limb movements, such as choreoathetosis, or ballismus,
- Contraindications for rTMS include non-removable metallic objects close to a coil and implanted electronic devices, such as cochlear implants and pacemakers.
Exclusion Criteria (TD):
- Syndromic or genetic brain-related associations,
- History of major trauma or brain surgery,
- Inability to remain still,
- History of Epilepsy,
- Severe coexisting sickness or illness unrelated to CP or unstable medical conditions such as pneumonia,
- Limb contractures caused by injury,
- Severe movement disorders that prevent intentional limb movements, such as choreoathetosis, or ballismus,
- Contraindications for rTMS include non-removable metallic objects close to a coil and implanted electronic devices, such as cochlear implants and pacemakers.
Opintosuunnitelma
Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Kaksinkertainen
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
|
Kokeellinen: Intervention Group 1
CP participants in the experiment intervention group 1 will receive rTMS using a figure-of-eight-shaped coil and rTMS stimulator (Nexstim, Finland) targeting the contralesional primary motor cortex.
The intervention will consist of 10 sessions, each lasting 20 minutes, spread over four weeks.
Each session will begin with priming: 10 minutes of 6-Hz rTMS at 90% of the resting motor threshold, delivered in two trains per minute (5 seconds per train with 25-second intervals between trains), totaling 600 priming pulses.
This will be followed immediately by 10 minutes of 1-Hz rTMS at 90% of the resting motor threshold, delivered continuously without interruption, totaling 600 low-frequency pulses.
|
All participants will undergo an MRI scan prior to the intervention to acquire T1-weighted images.
MRI data will be provided by the Cook Children's Radiology Department.
MRI scans will be used for neuronavigation.
rTMS is a safe, non-invasive way to map brain activity using gentle magnetic pulses.
A small coil is placed near the head to stimulate nerve cells without any pain.
This helps us understand how the brain controls movement.
High-density EEG (HD-EEG) is a safe and non-invasive brain imaging technique.
It involves placing a cap with small sensors on the child's head to measure the brain's electrical activity.
This technique does not send any energy into the brain.
The investigators will use the HD-EEG to measure motor-evoked potentials (MEPs) and TMS-evoked potentials (TEPs).
|
|
Kokeellinen: Intervention Group 2
CP Participants in experiment intervention group 2 will receive rTMS targeting the ipsilesional primary motor cortex.
The intervention will consist of 10 sessions, each lasting 20 minutes, spread over four weeks.
Each session will start with priming: 10 minutes of 6-Hz rTMS at 90% of the resting motor threshold, delivered in two trains per minute (5 seconds per train with 25-second intervals between trains), totaling 600 priming pulses.
This will be followed immediately by 10 minutes of 10 Hz rTMS at 90% of the resting motor threshold, delivered continuously without interruption, totaling 2000 high-frequency pulses.
|
All participants will undergo an MRI scan prior to the intervention to acquire T1-weighted images.
MRI data will be provided by the Cook Children's Radiology Department.
MRI scans will be used for neuronavigation.
rTMS is a safe, non-invasive way to map brain activity using gentle magnetic pulses.
A small coil is placed near the head to stimulate nerve cells without any pain.
This helps us understand how the brain controls movement.
High-density EEG (HD-EEG) is a safe and non-invasive brain imaging technique.
It involves placing a cap with small sensors on the child's head to measure the brain's electrical activity.
This technique does not send any energy into the brain.
The investigators will use the HD-EEG to measure motor-evoked potentials (MEPs) and TMS-evoked potentials (TEPs).
|
|
Huijausvertailija: Sham Group
CP participants in the sham group will receive sham rTMS by positioning the coil perpendicular to the scalp without delivering active stimulation, targeting both the contralesional and ipsilesional primary motor cortex.
The intervention will consist of 10 sessions, each lasting 20 minutes, spread over four weeks.
|
All participants will undergo an MRI scan prior to the intervention to acquire T1-weighted images.
MRI data will be provided by the Cook Children's Radiology Department.
MRI scans will be used for neuronavigation.
rTMS is a safe, non-invasive way to map brain activity using gentle magnetic pulses.
A small coil is placed near the head to stimulate nerve cells without any pain.
This helps us understand how the brain controls movement.
High-density EEG (HD-EEG) is a safe and non-invasive brain imaging technique.
It involves placing a cap with small sensors on the child's head to measure the brain's electrical activity.
This technique does not send any energy into the brain.
The investigators will use the HD-EEG to measure motor-evoked potentials (MEPs) and TMS-evoked potentials (TEPs).
|
|
Active Comparator: Control Group
Typically developed control group will complete a single baseline TMS-EEG session to measure TEPs.
This involves high-density EEG recording during single-pulse TMS to assess cortical excitability.
The session will last approximately 60-90 minutes.
|
All participants will undergo an MRI scan prior to the intervention to acquire T1-weighted images.
MRI data will be provided by the Cook Children's Radiology Department.
MRI scans will be used for neuronavigation.
High-density EEG (HD-EEG) is a safe and non-invasive brain imaging technique.
It involves placing a cap with small sensors on the child's head to measure the brain's electrical activity.
This technique does not send any energy into the brain.
The investigators will use the HD-EEG to measure motor-evoked potentials (MEPs) and TMS-evoked potentials (TEPs).
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Change on TMS-evoked potentials (TEPs)
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
TEPs refer to the electrical responses in the brain elicited by rTMS.
This technique involves applying magnetic pulses to specific brain areas, which induce electrical activity that can be recorded using EEG.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Change on cortical excitability - motor evoked potentials (MEPs)
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
MEPs are electrical signals generated by stimulating the brain's motor cortex and recorded from muscles.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
Muut tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Modified Ashworth Scale (MAS)
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
The Modified Ashworth Scale assesses spasticity in patients with central nervous system lesions or neurological disorders.
It provides a rapid and straightforward method for clinicians to evaluate spasticity while performing passive soft-tissue stretches.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
|
Mirror Movement Assessment
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
This evaluates the presence and severity of involuntary mirror movements, where movement in one limb is mirrored by involuntary movement in the opposite limb.
It provides a structured approach to quantify and monitor these movements, helping to gauge the impact of therapeutic interventions and track changes over time.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
|
Gross Motor Function Measure (GMFM-88)
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
It is a standardized observational tool specifically created and validated to assess changes in gross motor function over time in children with CP.
The GMFM-88 allows for the summation of item scores to generate raw and percentage scores for each of the five GMFM dimensions, the selected goal areas, and an overall GMFM-88 score.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
|
Adverse effects
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
Adverse effects of TMS-EEG can include temporary headaches, scalp discomfort, and mild skin irritation from EEG electrodes.
Rarely, individuals might experience transient cognitive effects or muscle twitching.
There is also a minimal risk of inducing seizures, particularly in those with a history of epilepsy.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
|
Finger Tapping Task
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
A keyboard tapping task measuring low-level motor ability and psychomotor speed.
Modeled after the Finger Tapping or Oscillation task from the Reitan Test Battery.
Participants tap a key as quickly as possible for multiple trials, testing dominant and/or non-dominant hand.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
|
Task Fitt's Law Task
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
Classic motor control task measuring the speed-accuracy tradeoff in rapid aimed movements.
Tests the relationship between movement time, distance, and target size, following Fitts' Law (MT = a + b*log2(2D/W)).
Participants rapidly move the mouse cursor from a home position to rectangular targets of varying sizes and distances.
Each trial begins at the home position on the left side of the screen.
When ready, participants move to the target rectangle as quickly as possible.
Movement time and accuracy are recorded for each trial.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
|
Pursuit Rotor
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
Motor tracking task requiring continuous tracking of a moving target with mouse or touch input.
Measures motor coordination and learning.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
|
Time Tapping Task
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
Motor timing task measuring self-paced tapping consistency across multiple trials.
Participants tap at a self-paced even rate following a visual entrainment period.
After seeing a flashing cross that demonstrates the target tapping rate, participants must maintain that rhythm for a sustained period (default 180 seconds per trial).
The task assesses low-level motor timing ability and may be sensitive to fatigue, sleep deprivation, and motor control deficits.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
|
Simple Reaction Time
Aikaikkuna: Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
A simple reaction time task where a single stimulus (an 'X' or mouse button prompt) appears at a specifiable delay from the previous response.
Measures basic alertness and motor response speed across multiple blocks with breaks.
|
Within the end of 4 weeks and 1-month follow-up of sham/real rTMS
|
Yhteistyökumppanit ja tutkijat
Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.
Sponsori
Tutkijat
- Päätutkija: Christos Papadelis, PhD, Cook Children's Health Care System
Julkaisuja ja hyödyllisiä linkkejä
Tutkimusta koskevien tietojen syöttämisestä vastaava henkilö toimittaa nämä julkaisut vapaaehtoisesti. Nämä voivat koskea mitä tahansa tutkimukseen liittyvää.
Yleiset julkaisut
- Colver A, Fairhurst C, Pharoah PO. Cerebral palsy. Lancet. 2014 Apr 5;383(9924):1240-9. doi: 10.1016/S0140-6736(13)61835-8. Epub 2013 Nov 20.
- Thut G, Pascual-Leone A. A review of combined TMS-EEG studies to characterize lasting effects of repetitive TMS and assess their usefulness in cognitive and clinical neuroscience. Brain Topogr. 2010 Jan;22(4):219-32. doi: 10.1007/s10548-009-0115-4. Epub 2009 Oct 28.
- Rosenbaum PL, Palisano RJ, Bartlett DJ, Galuppi BE, Russell DJ. Development of the Gross Motor Function Classification System for cerebral palsy. Dev Med Child Neurol. 2008 Apr;50(4):249-53. doi: 10.1111/j.1469-8749.2008.02045.x. Epub 2008 Mar 1.
- Reddihough D. Cerebral palsy in childhood. Aust Fam Physician. 2011 Apr;40(4):192-6.
- Carey JR, Anderson DC, Gillick BT, Whitford M, Pascual-Leone A. 6-Hz primed low-frequency rTMS to contralesional M1 in two cases with middle cerebral artery stroke. Neurosci Lett. 2010 Jan 29;469(3):338-42. doi: 10.1016/j.neulet.2009.12.023. Epub 2009 Dec 18.
- Cassidy JM, Chu H, Anderson DC, Krach LE, Snow L, Kimberley TJ, Carey JR. A Comparison of Primed Low-frequency Repetitive Transcranial Magnetic Stimulation Treatments in Chronic Stroke. Brain Stimul. 2015 Nov-Dec;8(6):1074-84. doi: 10.1016/j.brs.2015.06.007. Epub 2015 Jun 22.
- Hameed MQ, Dhamne SC, Gersner R, Kaye HL, Oberman LM, Pascual-Leone A, Rotenberg A. Transcranial Magnetic and Direct Current Stimulation in Children. Curr Neurol Neurosci Rep. 2017 Feb;17(2):11. doi: 10.1007/s11910-017-0719-0.
- Chung MG, Lo WD. Noninvasive brain stimulation: the potential for use in the rehabilitation of pediatric acquired brain injury. Arch Phys Med Rehabil. 2015 Apr;96(4 Suppl):S129-37. doi: 10.1016/j.apmr.2014.10.013. Epub 2014 Nov 6.
- Lerner AJ, Wassermann EM, Tamir DI. Seizures from transcranial magnetic stimulation 2012-2016: Results of a survey of active laboratories and clinics. Clin Neurophysiol. 2019 Aug;130(8):1409-1416. doi: 10.1016/j.clinph.2019.03.016. Epub 2019 Apr 6.
- Naeser MA, Martin PI, Nicholas M, Baker EH, Seekins H, Helm-Estabrooks N, Cayer-Meade C, Kobayashi M, Theoret H, Fregni F, Tormos JM, Kurland J, Doron KW, Pascual-Leone A. Improved naming after TMS treatments in a chronic, global aphasia patient--case report. Neurocase. 2005 Jun;11(3):182-93. doi: 10.1080/13554790590944663.
- Yeargin-Allsopp M, Van Naarden Braun K, Doernberg NS, Benedict RE, Kirby RS, Durkin MS. Prevalence of cerebral palsy in 8-year-old children in three areas of the United States in 2002: a multisite collaboration. Pediatrics. 2008 Mar;121(3):547-54. doi: 10.1542/peds.2007-1270.
- Croarkin PE, Wall CA, Lee J. Applications of transcranial magnetic stimulation (TMS) in child and adolescent psychiatry. Int Rev Psychiatry. 2011 Oct;23(5):445-53. doi: 10.3109/09540261.2011.623688.
- Gillick BT, Krach LE, Feyma T, Rich TL, Moberg K, Thomas W, Cassidy JM, Menk J, Carey JR. Primed low-frequency repetitive transcranial magnetic stimulation and constraint-induced movement therapy in pediatric hemiparesis: a randomized controlled trial. Dev Med Child Neurol. 2014 Jan;56(1):44-52. doi: 10.1111/dmcn.12243. Epub 2013 Aug 21.
- Abraham WC, Bear MF. Metaplasticity: the plasticity of synaptic plasticity. Trends Neurosci. 1996 Apr;19(4):126-30. doi: 10.1016/s0166-2236(96)80018-x.
- Pascual-Leone A, Amedi A, Fregni F, Merabet LB. The plastic human brain cortex. Annu Rev Neurosci. 2005;28:377-401. doi: 10.1146/annurev.neuro.27.070203.144216.
- Rajak BL, Gupta M, Bhatia D, Mukherjee A. Increasing Number of Therapy Sessions of Repetitive Transcranial Magnetic Stimulation Improves Motor Development by Reducing Muscle Spasticity in Cerebral Palsy Children. Ann Indian Acad Neurol. 2019 Jul-Sep;22(3):302-307. doi: 10.4103/aian.AIAN_102_18.
- Gupta M, Rajak BL, Bhatia D, Mukherjee A. Neuromodulatory effect of repetitive transcranial magnetic stimulation pulses on functional motor performances of spastic cerebral palsy children. J Med Eng Technol. 2018 Jul;42(5):352-358. doi: 10.1080/03091902.2018.1510555. Epub 2018 Sep 3.
- Zewdie E, Ciechanski P, Kuo HC, Giuffre A, Kahl C, King R, Cole L, Godfrey H, Seeger T, Swansburg R, Damji O, Rajapakse T, Hodge J, Nelson S, Selby B, Gan L, Jadavji Z, Larson JR, MacMaster F, Yang JF, Barlow K, Gorassini M, Brunton K, Kirton A. Safety and tolerability of transcranial magnetic and direct current stimulation in children: Prospective single center evidence from 3.5 million stimulations. Brain Stimul. 2020 May-Jun;13(3):565-575. doi: 10.1016/j.brs.2019.12.025. Epub 2019 Dec 30.
- Bar-On L, Molenaers G, Aertbelien E, Van Campenhout A, Feys H, Nuttin B, Desloovere K. Spasticity and its contribution to hypertonia in cerebral palsy. Biomed Res Int. 2015;2015:317047. doi: 10.1155/2015/317047. Epub 2015 Jan 11.
- Elbanna ST, Elshennawy S, Ayad MN. Noninvasive Brain Stimulation for Rehabilitation of Pediatric Motor Disorders Following Brain Injury: Systematic Review of Randomized Controlled Trials. Arch Phys Med Rehabil. 2019 Oct;100(10):1945-1963. doi: 10.1016/j.apmr.2019.04.009. Epub 2019 May 10.
- Manual Ability Classification System (MACS) http://www.macs.nu/
- Tadel F, Baillet S, Mosher JC, Pantazis D, Leahy RM. Brainstorm: a user-friendly application for MEG/EEG analysis. Comput Intell Neurosci. 2011;2011:879716. doi: 10.1155/2011/879716. Epub 2011 Apr 13.
- Barr MS, Farzan F, Davis KD, Fitzgerald PB, Daskalakis ZJ. Measuring GABAergic inhibitory activity with TMS-EEG and its potential clinical application for chronic pain. J Neuroimmune Pharmacol. 2013 Jun;8(3):535-46. doi: 10.1007/s11481-012-9383-y. Epub 2012 Jun 29.
- Iversen, J. R. & Makeig, S. MEG/EEG data analysis using EEGLAB. Magnetoencephalography: From signals to dynamic cortical networks 391-406 (2019).
- Canadian Occupational Performance Measure (COPM) http://www.thecopm.ca/
- Jebsen-Taylor Hand Function Test (JHFT): http://www.strokengine.ca/assess/jhft/
- Melbourne Assessment of Unilateral Upper Limb Function (MUUL): Access can be found at http://www.rch.org.au/melbourneassessment/
- Assessment of Motor and Process Skills (AMPS): Access can be found at http://www.innovativeotsolutions.com/content/amps/
- Krumlinde-Sundholm, L. & Eliasson, A.-C. Development of the Assisting Hand Assessment: a Rasch-built measure intended for children with unilateral upper limb impairments. Scand J Occup Ther 10, 16-26 (2003).
- Russell, D. J., Rosenbaum, P., Wright, M. & Avery, L. M. Gross Motor Function Measure (GMFM-66 & GMFM-88) Users Manual. (Mac keith press, 2002).
- Gupta, M., Rajak, B. L., Bhatia, D. & Mukherjee, A. Effect of repetitive transcranial magnetic stimulation on motor function and spasticity in spastic cerebral palsy. Int J Biomed Eng Technol 31, 365-374 (2019).
- Stanley, F. J., Blair, E., Alberman, E. & Alberman, E. D. Cerebral Palsies: Epidemiology and Causal Pathways. (Cambridge University Press, 2000).
- Diego, A. & Leung, A. Transcranial direct current stimulation for improving gross motor function in children with cerebral palsy: A systematic review. British Journal of Occupational Therapy 83, 030802261989788 (2020).
- Chen, X. J. & Li, S. C. Definition, classification and diagnostic conditions of cerebral palsy in children. Chinese Journal of Physical Medicine and Rehabilitation 29, 309 (2007).
- Mutanen TP, Biabani M, Sarvas J, Ilmoniemi RJ, Rogasch NC. Source-based artifact-rejection techniques available in TESA, an open-source TMS-EEG toolbox. Brain Stimul. 2020 Sep-Oct;13(5):1349-1351. doi: 10.1016/j.brs.2020.06.079. Epub 2020 Jul 10. No abstract available.
- Rogasch NC, Sullivan C, Thomson RH, Rose NS, Bailey NW, Fitzgerald PB, Farzan F, Hernandez-Pavon JC. Analysing concurrent transcranial magnetic stimulation and electroencephalographic data: A review and introduction to the open-source TESA software. Neuroimage. 2017 Feb 15;147:934-951. doi: 10.1016/j.neuroimage.2016.10.031. Epub 2016 Oct 20.
- Gilbert DL, Garvey MA, Bansal AS, Lipps T, Zhang J, Wassermann EM. Should transcranial magnetic stimulation research in children be considered minimal risk? Clin Neurophysiol. 2004 Aug;115(8):1730-9. doi: 10.1016/j.clinph.2003.10.037.
- Harb A, Margetis K, Kishner S. Modified Ashworth Scale. 2025 Apr 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK554572/
- Jung SH, Shin JE, Jeong YS, Shin HI. Changes in motor cortical excitability induced by high-frequency repetitive transcranial magnetic stimulation of different stimulation durations. Clin Neurophysiol. 2008 Jan;119(1):71-9. doi: 10.1016/j.clinph.2007.09.124. Epub 2007 Nov 26.
- Todd G, Flavel SC, Ridding MC. Priming theta-burst repetitive transcranial magnetic stimulation with low- and high-frequency stimulation. Exp Brain Res. 2009 May;195(2):307-15. doi: 10.1007/s00221-009-1791-8. Epub 2009 Apr 11.
- Kakuda W, Abo M, Kobayashi K, Momosaki R, Yokoi A, Fukuda A, Umemori T. Application of combined 6-Hz primed low-frequency rTMS and intensive occupational therapy for upper limb hemiparesis after stroke. NeuroRehabilitation. 2011;29(4):365-71. doi: 10.3233/NRE-2011-0714.
- Tallabs FA, Hammond-Tooke GD. Theta priming of 1-Hz rTMS in healthy volunteers: effects on motor inhibition. J Clin Neurophysiol. 2013 Feb;30(1):79-85. doi: 10.1097/WNP.0b013e31827ed0e3.
- Lee JC, Wilson AC, Corlier J, Tadayonnejad R, Marder KG, Pleman CM, Krantz DE, Wilke SA, Levitt JG, Ginder ND, Leuchter AF. Strategies for augmentation of high-frequency left-sided repetitive transcranial magnetic stimulation treatment of major depressive disorder. J Affect Disord. 2020 Dec 1;277:964-969. doi: 10.1016/j.jad.2020.09.011. Epub 2020 Sep 8.
- Gupta J, Gulati S, Singh UP, Kumar A, Jauhari P, Chakrabarty B, Pandey RM, Bhatia R, Jain S, Srivastava A. Brain Stimulation and Constraint Induced Movement Therapy in Children With Unilateral Cerebral Palsy: A Randomized Controlled Trial. Neurorehabil Neural Repair. 2023 May;37(5):266-276. doi: 10.1177/15459683231174222. Epub 2023 May 11.
- Pellicciari MC, Veniero D, Miniussi C. Characterizing the Cortical Oscillatory Response to TMS Pulse. Front Cell Neurosci. 2017 Feb 27;11:38. doi: 10.3389/fncel.2017.00038. eCollection 2017. No abstract available.
- Massimini M, Tononi G, Huber R. Slow waves, synaptic plasticity and information processing: insights from transcranial magnetic stimulation and high-density EEG experiments. Eur J Neurosci. 2009 May;29(9):1761-70. doi: 10.1111/j.1460-9568.2009.06720.x. Epub 2009 Apr 27.
- Ilmoniemi RJ, Kicic D. Methodology for combined TMS and EEG. Brain Topogr. 2010 Jan;22(4):233-48. doi: 10.1007/s10548-009-0123-4. Epub 2009 Dec 10.
- Daskalakis ZJ, Farzan F, Radhu N, Fitzgerald PB. Combined transcranial magnetic stimulation and electroencephalography: its past, present and future. Brain Res. 2012 Jun 29;1463:93-107. doi: 10.1016/j.brainres.2012.04.045. Epub 2012 Apr 28.
- Kirton A. Modeling developmental plasticity after perinatal stroke: defining central therapeutic targets in cerebral palsy. Pediatr Neurol. 2013 Feb;48(2):81-94. doi: 10.1016/j.pediatrneurol.2012.08.001.
- Casanova MF, Shaban M, Ghazal M, El-Baz AS, Casanova EL, Opris I, Sokhadze EM. Effects of Transcranial Magnetic Stimulation Therapy on Evoked and Induced Gamma Oscillations in Children with Autism Spectrum Disorder. Brain Sci. 2020 Jul 3;10(7):423. doi: 10.3390/brainsci10070423.
- Kirton A. Advancing non-invasive neuromodulation clinical trials in children: Lessons from perinatal stroke. Eur J Paediatr Neurol. 2017 Jan;21(1):75-103. doi: 10.1016/j.ejpn.2016.07.002. Epub 2016 Jul 9.
- Azizi S, Marzbani H, Raminfard S, Birgani PM, Rasooli AH, Mirbagheri MM. The impact of an anti-gravity treadmill (AlterG) training on walking capacity and corticospinal tract structure in children with cerebral palsy. Annu Int Conf IEEE Eng Med Biol Soc. 2017 Jul;2017:1150-1153. doi: 10.1109/EMBC.2017.8037033.
- Takeuchi N, Oouchida Y, Izumi S. Motor control and neural plasticity through interhemispheric interactions. Neural Plast. 2012;2012:823285. doi: 10.1155/2012/823285. Epub 2012 Dec 26.
- Cox BC, Cincotta M, Espay AJ. Mirror movements in movement disorders: a review. Tremor Other Hyperkinet Mov (N Y). 2012;2:tre-02-59-398-1. doi: 10.7916/D8VQ31DZ. Epub 2012 Apr 16.
- Fling BW, Seidler RD. Task-dependent effects of interhemispheric inhibition on motor control. Behav Brain Res. 2012 Jan 1;226(1):211-7. doi: 10.1016/j.bbr.2011.09.018. Epub 2011 Sep 16.
- Kuo HC, Ferre CL, Chin KY, Friel KM, Gordon AM. Mirror movements and brain pathology in children with unilateral cerebral palsy. Dev Med Child Neurol. 2023 Feb;65(2):264-273. doi: 10.1111/dmcn.15322. Epub 2022 Jun 24.
- Green LB, Hurvitz EA. Cerebral palsy. Phys Med Rehabil Clin N Am. 2007 Nov;18(4):859-82, vii. doi: 10.1016/j.pmr.2007.07.005.
- Hayes C. Cerebral palsy: classification, diagnosis and challenges of care. Br J Nurs. 2010 Mar 25-Apr 7;19(6):368-73. doi: 10.12968/bjon.2010.19.6.47249.
- Sun YY, Wang L, Peng JL, Huang YJ, Qiao FQ, Wang P. Effects of repetitive transcranial magnetic stimulation on motor function and language ability in cerebral palsy: A systematic review and meta-analysis. Front Pediatr. 2023 Feb 16;11:835472. doi: 10.3389/fped.2023.835472. eCollection 2023.
- Soleimani F, Vameghi R, Biglarian A. Antenatal and intrapartum risk factors for cerebral palsy in term and near-term newborns. Arch Iran Med. 2013 Apr;16(4):213-6.
Opintojen ennätyspäivät
Nämä päivämäärät seuraavat ClinicalTrials.gov-sivustolle lähetettyjen tutkimustietueiden ja yhteenvetojen edistymistä. National Library of Medicine (NLM) tarkistaa tutkimustiedot ja raportoidut tulokset varmistaakseen, että ne täyttävät tietyt laadunvalvontastandardit, ennen kuin ne julkaistaan julkisella verkkosivustolla.
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Arvioitu)
Perjantai 1. toukokuuta 2026
Ensisijainen valmistuminen (Arvioitu)
Maanantai 1. toukokuuta 2028
Opintojen valmistuminen (Arvioitu)
Lauantai 1. kesäkuuta 2030
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Tiistai 28. huhtikuuta 2026
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Tiistai 28. huhtikuuta 2026
Ensimmäinen Lähetetty (Todellinen)
Tiistai 5. toukokuuta 2026
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Torstai 14. toukokuuta 2026
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Tiistai 12. toukokuuta 2026
Viimeksi vahvistettu
Perjantai 1. toukokuuta 2026
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- 2024-100 (Comité Etico Cientifico Facultad de Medicina Universidad del Desarrollo Clínica Alemana)
Yksittäisten osallistujien tietojen suunnitelma (IPD)
Aiotko jakaa yksittäisten osallistujien tietoja (IPD)?
PÄÄTTÄMÄTÖN
Lääke- ja laitetiedot, tutkimusasiakirjat
Tutkii yhdysvaltalaista FDA sääntelemää lääkevalmistetta
Ei
Tutkii yhdysvaltalaista FDA sääntelemää laitetuotetta
Joo
Yhdysvalloissa valmistettu ja sieltä viety tuote
Ei
Nämä tiedot haettiin suoraan verkkosivustolta clinicaltrials.gov ilman muutoksia. Jos sinulla on pyyntöjä muuttaa, poistaa tai päivittää tutkimustietojasi, ota yhteyttä register@clinicaltrials.gov. Heti kun muutos on otettu käyttöön osoitteessa clinicaltrials.gov, se päivitetään automaattisesti myös verkkosivustollemme .