Identifying Personalized Brain States Predicting Residual Corticospinal Tract Output After Stroke

Launched by UNIVERSITY OF TEXAS AT AUSTIN · Apr 10, 2024

Keywords

ClinConnect Summary

This clinical trial is studying a new approach to help stroke survivors recover their hand movements by using a technique called transcranial magnetic stimulation (TMS). The researchers believe that applying TMS during certain patterns of brain activity can help strengthen connections in the brain that control hand movement, which may lead to better recovery. They are especially interested in how to personalize this treatment based on each person's unique brain activity.

To participate in the study, individuals must have had a stroke more than six months ago and still experience weakness in their arm or hand. They should also be able to provide informed consent and have certain scores on tests that measure their cognitive function and movement abilities. Participants will visit the lab for two days, where they will undergo assessments to determine their eligibility and receive the TMS treatment. During these visits, they will have electrodes placed on their scalp and muscles to measure brain and muscle responses. The study aims to recruit 20 stroke survivors, and participation could offer insights into new ways to improve hand recovery after a stroke.

Gender

ALL

Eligibility criteria

• • Presence of residual upper extremity hemiparesis, defined as any of the following Fugl Meyer Upper Extremity Score \<66 Wolf Motor Function Test Score \<70 Affected hand performance on the 9-Hole Peg Test \>= 10% worse than unaffected hand Affected hand pinch, key, or power grip performance \>= 10% worse than unaffected hand
• • Occurrence of ischemic or hemorrhagic stroke \>= 6 months before participation
• • Willingness and ability to provide informed consent
• • No history of neurological disease and/or neurological injury other than stroke
• * No TMS contraindications, including but not limited to:
• • Cardiac pacemaker Cochlear implant Cortical stimulator Deep brain stimulator Vagus nerve stimulator Cervical spine epidural stimulation Ventriculoperitoneal shunt Ferromagnetic metallic implants above the level of the seventh cervical vertebra Seizure in the last 12 months while taking anti-epilepsy medication History of adverse reactions to TMS or peripheral nerve stimulation Current, suspected, or planned pregnancy Any recent changes (within the last month) to medication use
• • - Presence of residual corticospinal connections innervating an affected upper extremity muscle following stimulation of the lesioned hemisphere (i.e., MEP+), evaluated at rest