Investigating the Effects of Transcranial Direct Current Stimulation to Different Brain Regions on Ankle Tracking Motor Learning, Motor Adaptation, and Brain Connectivity in Healthy Middle-aged and Older Adults and Patients With Subcortical Stroke

Launched by NATIONAL TAIWAN UNIVERSITY HOSPITAL · Aug 12, 2024

Keywords

ClinConnect Summary

This clinical trial is studying a new brain stimulation technique called transcranial direct current stimulation (tDCS) to see how it affects ankle control and movement in both healthy older adults and patients who have had a stroke. Good ankle control is important for maintaining balance and preventing falls, especially in middle-aged and older individuals and those recovering from a stroke. The researchers want to find out if applying tDCS to different areas of the brain can improve motor learning (how we learn to move), motor adaptation (how we adjust our movements), and brain connections.

To participate, you must be between 40 and 80 years old, have good cognitive function, and have normal ankle strength and movement. Healthy participants who meet these criteria will be included, while those with certain medical conditions or neurological issues will not be eligible. Stroke patients must have had their first stroke at least three months earlier, be able to move their affected ankle a little, and have mild to moderate disability. Participants will receive tDCS while being monitored and will help researchers better understand how this therapy can aid in recovery and improve movement skills.

Gender

ALL

Eligibility criteria

• • Inclusion Criteria: Part 1: healthy middle-aged and older adults
• • 1. age between 40 and 80 years old
• • 2. intact cognitive function (MMSE ≧ 27)
• • 3. normal ankle dorsiflexor and plantarflexor strength (manual muscle strength testing= 5) and passive range of motion (ankle dorsiflexion ≧10 degrees; ankle plantarflexion ≧ 45 degrees)
• • 4. corrected far vision ≥ 0.8 (Landolt C test) and uncorrected near vision ≥ 0.04 (Comprehensive Color Blindness Checklist)
• • Exclusion Criteria: Part 1: healthy middle-aged and older adults
• • 1. having any contraindications for MRI or tDCS;
• • 2. serious or uncontrolled systematic diseases;
• • 3. symptoms or history of neurological diseases, including transient ischemic attack, stroke, epilepsy, history of abnormal electroencephalogram (EEG), meningitis, encephalitis, brain tumors, brain surgery, and sensory disorders, etc.;
• • 4. severe musculoskeletal problems that would affect lower limb functions;
• • 5. visual spatial perception disorders and hearing loss;
• • 6. color blindness;
• • 7. depression and psychiatric disorders;
• • 8. use of any medication that could affect the central nervous system function;
• • 9. drug, substance, or alcohol addiction;
• • 10. those participating in research involving invasive or non-invasive brain stimulation;
• • 11. those deemed unsuitable for MRI or tDCS after evaluation by the attending physician;
• • 12. those affiliated with any research-conducting institution.
• • Inclusion Criteria: Part 2: patients with chronic subcortical stroke
• • 1. aged between 40 and 80 years old;
• • 2. intact cognitive function (MMSE ≥ 27);
• • 3. first-ever onset of subcortical stroke occurring at least 3 months prior to enrollment, with brain lesions involving unilateral subcortical regions only;
• • 4. hemiplegic or hemiparetic;
• • 5. no spatial neglect;
• • 6. able to actively perform at least 5 degrees of ankle dorsiflexion and 10 degrees of ankle plantarflexion with the affected ankle;
• • 7. no excessive spasticity;
• • 8. no severe contracture (passive range of motion ≥ 10 degrees for ankle dorsiflexion and ≥ 20 degrees for ankle plantarflexion) in the affected leg;
• • 9. mild-to moderate disability;
• • 10. can walk independently or under supervision without assistance;
• • 11. corrected far vision ≥ 0.8 (Landolt C test) and uncorrected near vision ≥ 0.04 (Comprehensive Color Blindness Checklist.)
• • Exclusion Criteria: Part 2: patients with chronic subcortical stroke The exclusion criteria will be the same as those listed for healthy participants described in Part 1 except for items (3) and (4). Item (3) will be changed to "(3a) symptoms or history of other neurological diseases, including epilepsy, history of abnormal EEG, meningitis, encephalitis, brain tumors, brain surgery, and sensory disorders, etc." and item (4) will be changed to "(4a) severe musculoskeletal problems of the non-hemiparetic limbs that would affect mobility functions".