Brain-Oscillation-Synchronized Stimulation to Enhance Motor Recovery in Early Subacute Stroke
We will investigate the therapeutic efficacy of EEG-synchronized noninvasive repetitive transcranial magnetic stimulation (rTMS) in the early subacute phase after ischemic stroke to improve upper limb motor rehabilitation. We hypothesize that synchronization of rTMS with the phase of the ongoing sensorimotor oscillation indicating high corticospinal excitability leads to significantly stronger improvement of paretic upper limb motor function than the same rTMS protocol non-synchronized to the ongoing sensorimotor oscillation or sham stimulation.
⁃ Subjects meeting all of the following criteria will be considered for admission to the trial:
• Age ≥ 18 years at the time of signing the informed consent.
• Cerebral ischemia identified by brain imaging (cerebral MRI or CT) occurred 1-14 days ago.
• Subject understands and voluntarily signs an informed consent document prior to any study related assessments/procedures.
• Stroke has resulted in a new arm-/hand motor deficit with ≤ 50 points in the FMA-UE.
• Presence of motor evoked potentials (MEPs) in the paretic hand. MEPs has to be obtained in the resting muscle
• o If no MEPs can be obtained, MEP search procedure can be repeated later up to 14 days after stroke onset.
• ● μ-oscillation (8-12 Hz) is recordable by EEG in the ipsilesional sensorimotor cortex with a sufficient signal-to-noise ratio of at least 3 dB
• ● Subject is able to adhere to the study visit schedule and other protocol requirements.