Optimization of Time Parameters of Priming iTBS for Poststroke Motor Rehabilitation

Launched by THE HONG KONG POLYTECHNIC UNIVERSITY · Sep 21, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how different time intervals between two types of brain stimulation, called continuous theta burst stimulation (cTBS) and intermittent theta burst stimulation (iTBS), can help improve recovery for patients who have had a stroke. The trial aims to find out if these stimulation methods, when combined with standard robot-assisted training, can enhance the brain's ability to heal and improve movement in the arms of stroke survivors. Researchers will use special brain wave monitoring (electroencephalography or EEG) to see how these treatments affect the brain's recovery process.

To participate in the trial, individuals must be between 18 and 75 years old, have experienced their first stroke at least six months ago, and have some remaining difficulty moving their arm. They should also be able to read and understand Chinese and provide signed consent to join. However, those with serious medical conditions, severe movement difficulties, or cognitive issues that prevent them from following instructions will not be eligible. Participants can expect to engage in brain stimulation and robotic training, contributing to important research that could lead to better rehabilitation methods for stroke survivors in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. diagnosis of hemorrhagic or ischemic stroke using computed tomography (CT) or magnetic resonance imaging (MRI).
• • 2. the first-ever stroke with unilateral hemiplegia.
• • 3. 18-75 years old.
• • 4. chronic stroke ( ≥ 6 months).
• • 5. residual hemiparetic upper limb functional level 2-6 in the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK).
• • 6. can understand and read Chinese.
• • 7. signed informed consent.
• Exclusion Criteria:
• • 1. diagnosis of any clinically significant or unstable medical disorder.
• • 2. any contraindications to TMS based on the TMS safety guidelines (Rossi, Hallett, Rossini, \& Pascual-Leone, 2011).
• • 3. inability to follow treatment instructions due to severe cognitive (using the Hong Kong version of the Montreal Cognitive Assessment (MoCA-HK) \< 22/30) and communication deficiency.
• • 4. extreme spasticity over the hemiparetic upper limb (Modified Ashworth Score\>2) or severe pain that hindered movement.
• • 5. a history of neurological or psychiatric disease excluding stroke, or current use of psychoactive medication (sedatives, antipsychotics, antidepressants, etc.).