PCMS Task After Moderate-to-severe Stroke

Launched by UNIVERSITY OF UTAH · Feb 10, 2023

Keywords

ClinConnect Summary

Researchers at the University of Pittsburgh are conducting a study to find out if a combination of brain, nerve, and hand stimulation can help improve hand movement in people who have had a moderate to severe stroke. This study aims to see if this combined therapy can strengthen the connection between the brain and the hand muscles that are weak after a stroke, and whether it can also help participants move their hands better and perform daily tasks more effectively.

To be eligible for this study, participants should be aged between 18 and 85 and must have had their first stroke at least six months ago. They should be able to grasp a small object and have sufficient cognitive ability to engage in the study. However, individuals with certain conditions, such as severe muscle stiffness, other neurological disorders, or those who cannot undergo MRI scans due to medical implants, will not be included. Participants can expect to receive specialized stimulation treatments and will be monitored to assess how their hand movement improves over the course of the study.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Age between 18-85 years
• • 2. Diagnosis of first-ever subcortical stroke (single cerebrovascular accident)
• • 3. Stroke onset of at least six months prior to the time of participation
• • 4. A score of at least 1 out of 2 on the spherical grasping item of the Fugl-Meyer Upper Extremity Subscale to allow participants to grasp the ball
• • 5. Cognitive skills to actively participate, as indicated by scores of \> 23 on the Mini-Mental Status Examination
• • 6. English speaking
• Exclusion Criteria:
• • 1. Inability to elicit a motor evoked potential (MEP) in the EDC muscle even with a 20% background muscle contraction
• • 2. Presence of severe aphasia
• • 3. Excessive spasticity of the wrist and finger muscles, defined as a Modified Ashworth Score \>2
• • 4. Diagnosis of neurological disorders other than stroke
• • 5. History of seizure or epilepsy
• • 6. Orthopedic/musculoskeletal conditions (e.g., arthritis) affecting the upper extremity
• • 7. Presence of metallic implants in the head or neck
• • 8. Currently or planning to become pregnant
• • 9. Difficulty maintaining alertness or remaining still
• • 10. Ferromagnetic metallic implants, pacemakers, other implanted devices, or ventilators for magnetic resonance imaging (MRI)
• • 11. Bodyweight \> 300 lbs due to MRI scanner dimensions (for subjects also undergoing MRI)
• • 12. Psychiatric diagnosis according to the criteria of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-V), or who are on psychotropic medication
• • 13. Life expectancy less than the duration of the study
• • 14. Excessive pain in the paretic hand, defined as a Visual Analog Scale Score \>4
• • 15. Participation in concurrent occupational therapy
• • 16. Current use of recreational drugs and stimulants like cocaine and methylenedioxymethamphetamine (MDMA)