Real-time Personalized Brain State-dependent TMS After Stroke

Launched by UNIVERSITY OF TEXAS AT AUSTIN · Jul 29, 2024

Keywords

ClinConnect Summary

This clinical trial is exploring a new treatment for people who have had a stroke more than six months ago and are experiencing weakness in their arm. The study focuses on a technique called transcranial magnetic stimulation (TMS), which uses magnetic fields to activate parts of the brain involved in movement. Researchers want to see if a personalized approach to TMS, which depends on the individual's specific brain activity, can improve hand function better than the standard method. This trial aims to understand how well this personalized TMS can help activate the brain areas that control movement and how this relates to improving motor skills in the affected hand.

To participate, individuals must be between 65 and 74 years old, have had a stroke in the past, and still show some weakness in their arm. They should also be able to understand the study and provide consent. Participants will undergo TMS treatments and will be monitored to see how their motor skills change. It's important to note that some people may not qualify due to other medical conditions or specific health devices they might have. Overall, this trial represents a hopeful step toward better recovery options for stroke survivors.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • History of stroke \>6 months ago
• • Presence of residual upper extremity hemiparesis
• • Willingness to participate
• • Ability to provide informed consent
• • Upper extremity Fugl-Meyer score \< 66
• • Mini Mental State Exam score \> 24
• • Discernable and reliable motor-evoked potential (MEP) following single-pulse transcranial magnetic stimulation to the lesioned hemisphere
• Exclusion Criteria:
• • History of neurological disease and/or neurological injury other than stroke
• • Presence of contraindications to transcranial magnetic stimulation (TMS) or peripheral nerve stimulation (PNS) including: cardiac pacemaker, cochlear implant, cortical stimulator, deep brain stimulator, vagus nerve stimulator, cervical spine epidural stimulator, and/or ventriculoperitoneal shunt, ferromagnetic metallic implants above the level of the seventh cervical vertebrae, seizure in the last 12 months while taking anti-epilepsy medication, history of adverse reactions to TMS or PNS
• • current, suspected, or planned pregnancy
• • recent changes (within the last month) to medication use
• • Upper extremity Fugl-Meyer score = 66
• • Mini Mental State Exam score \<= 24
• • No discernible or reliable MEP elicited following single-pulse TMS to the lesioned hemisphere