Determine the Effect of Targeted High-definition tDCS on Reducing Post-stroke Upper Limb Motor Impairments

Status: Recruiting
Location: See location...
Intervention Type: Device
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Significant motor impairments occur in 80% of individuals after moderate to severe stroke and impact the body side to the lesioned hemisphere. Typical motor impairments involve loss of dexterity with highly prevalent upper limb flexion synergy. Advances in treating flexion synergy impairments have been hampered by a lack of precision rehabilitation. Previous studies suggest and support the role of cortico-reticulospinal tract (CRST) hyperexcitability in post-stroke flexion synergy. CRST hyperexcitability is often caused by damage to the corticospinal tract (CST). We hypothesize that: 1) inhibiting the contralesional dorsal premotor cortex (cPMd) will directly reduce the CRST hyperexcitability and thus, reduce the expression of the flexion synergy; 2) facilitating the ipsilesional primary motor cortex (iM1) will improve the excitability of the damaged CST, therefore reducing the CRST hyperexcitability and the flexion synergy. we propose to use a novel targeted high-definition tDCS (THD-tDCS) to specifically modulate the targeted cortical regions for testing his hypothesis, via the following aims: Aim 1. Evaluate the effect of cathodal THD-tDCS over the cPMd on reducing the CRST hyperexcitability and the expression of flexion synergy. Aim 2. Evaluate the effect of anodal THD-tDCS over the iM1 on improving the excitability of the CST, and determine whether this, thus, also reduces the CRST hyperexcitability and the flexion synergy. Aim 3. Evaluate the confluence effect of bilateral THD-tDCS, i.e., simultaneous cathodal stimulation over the cPMd and anodal over the iM1.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 90
Healthy Volunteers: f
View:

• Paresis confined to one side, with substantial motor impairment of the paretic upper limb

• Capacity to provide informed consent

Locations
United States
Illinois
Carle Foundation Hospital
RECRUITING
Urbana
Contact Information
Primary
Yuan Yang, PhD
yuan.yang@carle.com
217-244-5870
Backup
Sanjiv Jain, MD
sanjiv.jain@carle.com
217-383-3800
Time Frame
Start Date: 2022-09-30
Estimated Completion Date: 2026-01-30
Participants
Target number of participants: 30
Treatments
Active_comparator: Anodal stimulation
Anodal stimulation targets the primary motor cortex (arm area) in the lesioned hemisphere, sham on the contralesional hemisphere.
Active_comparator: Cathodal stimulation
Cathodal stimulation targets the dorsal premotor cortex (arm area) in the contralesional hemisphere, sham on the lesioned hemisphere.
Active_comparator: Bilateral Stimulation
Anodal stimulation targets the primary motor cortex (arm area) in the lesioned hemisphere and cathodal stimulation targets the dorsal premotor cortex (arm area) in the contralesional hemisphere at the same time.
Sham_comparator: Sham stimulation
Sham stimulation to both hemisphere of the brain
Related Therapeutic Areas
Sponsors
Leads: Carle Foundation Hospital
Collaborators: American Heart Association

This content was sourced from clinicaltrials.gov