Neural Network Reorganization Associated With Upper Limb Motor Recovery in Stroke Patients- Establishing a Prognostic Model and Tailoring Neuromodulation for Rehabilitation

Status: Recruiting
Location: See all (2) locations...
Intervention Type: Device
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

This main aim of the study is to investigate the changes in neurophysiological features after stroke, and its association with upper limb motor recovery, so as to establish a prognostic model for upper limb motor recovery after stroke. The investigators hypothesize that a combination of neurophysiological features measured by transcranial magnetic stimulation (TMS), high density electroencephalography (HD-EEG), functional magnetic resonance imaging (fMRI) and Diffusion Tensor Imaging (DTI) might be used as biomarkers to predict upper limb motor outcomes after stroke. The investigators also hypothesize that non-invasive brain stimulation strategies such as tDCS will more effectively improve motor outcomes as an adjunct to therapy, if tailored according to patient's predicted pattern of neural reorganization.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 21
Maximum Age: 80
Healthy Volunteers: t
View:

⁃ 21-80 years old;

• First ever stroke less than 6 weeks;

• Moderate to severe upper limb impairment with Manual Muscle Testing (MMT) score on shoulder abduction plus finger extension (SAFE) \<5 within the first week post-stroke.

⁃ Age 21-80 years old;

• No known medical history.

Locations
Other Locations
Singapore
Alexandra Hospital
RECRUITING
Singapore
National University Hospital
RECRUITING
Singapore
Contact Information
Primary
Effie Chew, MBBS
effie_chew@nuhs.edu.sg
67726198
Backup
Ning Tang, PhD
ning_tang@nuhs.edu.sg
Time Frame
Start Date: 2020-09-01
Estimated Completion Date: 2026-07-16
Participants
Target number of participants: 68
Treatments
Experimental: Anodal tDCS stimulation to the ipsilesional M1
Participant will receive 1 mA anodal tDCS stimulation to the ipsilesional M1 of cortical representation of the affected upper limb.~Cathode will be used as reference electrode and placed over the supraorbital area contralateral to the anode. tDCS stimulation will be conducted daily for 20 sessions in consecutive days in the 4th month after stroke, with each session lasting for 20 minutes and combined with online occupational therapy training.
Experimental: Anodal tDCS to the contralesional premotor cortex
Participant will receive 1mA anodal tDCS to the contralesional premotor cortex. Cathode will be used as reference electrode and placed over the supraorbital area contralateral to the anode. tDCS stimulation will be conducted daily for 20 sessions in consecutive days in the 4th month after stroke, with each session lasting for 20 minutes and combined with online occupational therapy training.
Sham_comparator: Sham tDCS
Participant will receive sham tDCS stimulation with anode placed over the scalp area corresponding to ipsilesional M1.~Cathode will be used as reference electrode and placed over the supraorbital area contralateral to the anode. tDCS stimulation will be conducted daily for 20 sessions in consecutive days in the 4th month after stroke, with each session lasting for 20 minutes and combined with online occupational therapy training.
No_intervention: Control group
Subjects who fulfill the inclusion criteria of Study 2 but refuse tDCS stimulation.
Related Therapeutic Areas
Sponsors
Collaborators: Nanyang Technological University, National University of Singapore, Alexandra Hospital
Leads: National University Hospital, Singapore

This content was sourced from clinicaltrials.gov