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Optimizing Transcranial Direct Current Stimulation for Motor Recovery From Hemiparesis
Optimizing Transcranial Direct Current Stimulation for Motor Recovery From Severe Post-stroke Hemiparesis
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
This study has 2 aims: 1) determine which transcranial direct current stimulation (tDCS) electrode configuration is most effective in combination with motor training to promote motor recovery from severe post-stroke hemiparesis; and 2) begin to clarify the extent to which baseline transcranial magnetic stimulation (TMS) measures predict response to tDCS, as well as the effects of tDCS paired with motor training on TMS measures of motor cortical organization.
To accomplish these aims, the investigators will recruit 36 human subjects with severe post-stroke hemiparesis and assign each subject to 1 of 4 tDCS conditions (anodal excitatory ipsilesional; cathodal inhibitory contralesional; a combination of anodal excitatory ipsilesional during cathodal inhibitory contralesional; or sham). Each subject will undergo a 20-minute stimulation session once a day for 10 days over a 2-week period. Each session will be followed by 3 hours of intensive, task-oriented upper extremity motor training.
Outcome measures for this study include TMS motor cortical maps and standardized tests of motor performance. The investigators hypothesize that all groups will show improvement in all measures; however, both the anodal excitatory ipsilesional group and the cathodal inhibitory contralesional group will show significantly greater improvement compared with the other 2 groups. The investigators will also find evidence clarifying whether the presence or absence of motor-evoked potentials (MEPs) has predictive value regarding which tDCS configuration would be most effective for a particular subject.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Chronic stroke patients
- Single stroke
- Chronic (more than 12 months after from stroke)
- At least 18 years old, but there is no upper age range for this project.
- Participants NOT able to extend the affected metacarpophalangeal joints at least 10° and the wrist 20°.
Exclusion Criteria:
- History of head injury with loss of consciousness, seizure, severe alcohol or drug abuse, psychiatric illness
- Within 3 months of recruitment, use of drugs known to exert detrimental effects on motor recovery
- Cognitive deficit severe enough to preclude informed consent
- Positive pregnancy test or being of childbearing age and not using appropriate contraception
- Participants with history of untreated depression.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verdrievoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Actieve vergelijker: Anodal tDCS with motor training
20 minutes of anodal transcranial direct current stimulation applied to the ipsilesional hemisphere (intervention) paired with 3 hours of intensive, task-oriented upper extremity motor training.
Transcranial direct current stimulation will be delivered using the Neuroconn Eldith stimulator by Magstim.
|
Transcranial direct current stimulation to the ipsilesional hemisphere, contralesional hemisphere, or both, paired with task-oriented therapy.
|
|
Actieve vergelijker: Cathodal tDCS with motor training
20 minutes of cathodal transcranial direct current stimulation applied to the contralesional hemisphere (intervention) paired with 3 hours of intensive, task-oriented upper extremity motor training.
Transcranial direct current stimulation will be delivered using the Neuroconn Eldith stimulator by Magstim.
|
Transcranial direct current stimulation to the ipsilesional hemisphere, contralesional hemisphere, or both, paired with task-oriented therapy.
|
|
Actieve vergelijker: Dual tDCS with motor training
20 minutes of anodal transcranial direct current stimulation applied to the ipsilesional hemisphere and cathodal transcranial direct current stimulation applied to the contralesional hemisphere (intervention) paired with 3 hours of intensive, task-oriented upper extremity motor training.
Transcranial direct current stimulation will be delivered using the Neuroconn Eldith stimulator by Magstim.
|
Transcranial direct current stimulation to the ipsilesional hemisphere, contralesional hemisphere, or both, paired with task-oriented therapy.
|
|
Sham-vergelijker: Sham tDCS with motor training
20 minutes of sham transcranial direct current stimulation applied to the ipsilesional hemisphere (intervention) paired with 3 hours of intensive, task-oriented upper extremity motor training.
Transcranial direct current stimulation will be delivered using the Neuroconn Eldith stimulator by Magstim.
|
Transcranial direct current stimulation to the ipsilesional hemisphere, contralesional hemisphere, or both, paired with task-oriented therapy.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
|
Change in Fugl Meyer Assessment
Tijdsspanne: Score change after 10 days of intervention compared to baseline; Score change after 1-month after the intervention compared to baseline
|
Score change after 10 days of intervention compared to baseline; Score change after 1-month after the intervention compared to baseline
|
Secundaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
|
Change in Action Research Arm Test
Tijdsspanne: Score change after 10 days of intervention compared to baseline; Score change after 1-month after the intervention compared to baseline
|
Score change after 10 days of intervention compared to baseline; Score change after 1-month after the intervention compared to baseline
|
|
Change in Stroke Impact Scale
Tijdsspanne: Score change after 10 days of intervention compared to baseline; Score change after 1-month after the intervention compared to baseline
|
Score change after 10 days of intervention compared to baseline; Score change after 1-month after the intervention compared to baseline
|
Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 11CRP7220009
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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Klinische onderzoeken op Neuroconn Eldith stimulator by Magstim
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Ludwig-Maximilians - University of MunichVoltooidTherapiebestendige zware depressieDuitsland
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Institut National de la Santé Et de la Recherche...Assistance Publique - Hôpitaux de ParisVoltooidPrikkelbaarheid van diafragmatische primaire motorcortexFrankrijk
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Centre d'Investigation Clinique et Technologique...Adep AssistanceVoltooid
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Centre Hospitalier Universitaire de BesanconUniversity Hospital, Grenoble; Rennes University Hospital; Clinical Investigation... en andere medewerkersVoltooidBipolaire stoornis | Unipolaire depressie | Resistente depressie | StemmingsstoornissenFrankrijk
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University of Southern CaliforniaNational Institutes of Health (NIH); Crowley Carter Foundation; Don and Linda Carter...OnbekendDystonie met aanvang in de kindertijdVerenigde Staten
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Institut National de la Santé Et de la Recherche...BeëindigdHartinfarct | AfasieFrankrijk
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Schoen Clinic Bad AiblingGerman Center for Vertigo and Balance DisordersOnbekendRuimtelijke verwaarlozing na rechter hersenbeschadigingDuitsland
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Pusan National UniversityOnbekendHartinfarctKorea, republiek van
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Iris SommerOnbekendPersoonlijkheidsstoornissen | Psychotische stoornissen | Stemmingsstoornissen | Stressstoornissen, posttraumatisch | GehoorstoornissenNederland