Upper limb motor dysfunction after stroke
Conditions
Interventions
Part III: Experimental group A:Low-frequency rTMS
Part III: Experimental group C:High-frequency rTMS combined low-frequency rTMS
Part I: Experimental group:Motor imagery brain-computer interface therapy
Part III: Experimental group B:High-frequency rTMS
Part I: Control group:Conventional Physical Rehabilitation
Sponsors
Shanghai Yangzhi rehabilitation hospital
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: Part I: 1.Confirmed by head CT or MRI as a stroke (including ischemic stroke or hemorrhagic stroke), and with unilateral upper limb motor dysfunction remaining after the stroke (modified Fugl-Meyer Upper Extremity score FMA-UE = 2 weeks; 4.The muscle tone of the affected upper limb has not reached the spastic stage (modified Ashworth scale = 24, and the patient must have the ability to understand motor imagery tasks (e.g., imagining grasping and extending) and cooperate with a 2-week rehabilitation training. Part III: 1.Confirmed by head CT or MRI as a stroke (including ischemic stroke or hemorrhagic stroke), and with unilateral upper limb motor dysfunction remaining after the stroke (modified Fugl-Meyer Upper Extremity score FMA-UE = 2 weeks; 4.The muscle tone of the affected upper limb has not reached the spastic stage (modified Ashworth scale = 24, and the patient must have the ability to understand motor imagery tasks (e.g., imagining grasping and extending) and cooperate with rehabilitation training; 7.Commitment to complete 3 months of follow-up (including functional assessment and neuroimaging examination), and ability to regularly attend follow-up visits at the collaborating institution.
Exclusion criteria
Exclusion criteria: 1.Secondary paralysis: Motor dysfunction of the upper limbs caused by trauma, neurodegenerative diseases (such as Parkinson's disease, amyotrophic lateral sclerosis), or congenital neuromuscular disorders (such as spinal muscular atrophy); 2.Comorbid severe systemic diseases: Comorbid with severe cardiovascular and cerebrovascular diseases (such as uncontrolled hypertension, coronary heart disease, epilepsy), mental disorders (such as depression, schizophrenia); 3.Previous BCI-related interventions: Before participating in this study for the first time, they had already received rehabilitation training based on motor imagery using brain-computer interfaces. 4.Skin or body surface contraindications: If the skin on the affected upper limb is damaged, inflamed, or has metal implants (such as internal fixation for fractures), it may interfere with the attachment of EEG electrodes or the safety of TMS stimulation; 5.Epilepsy risk: History of previous epileptic seizures or new-onset epilepsy after stroke, and no regular antiepileptic drug treatment; 6.Drug interference: Currently taking antiepileptic drugs (such as benzodiazepines), sedatives (such as benzodiazepines, barbiturates). Part III: 1.Secondary paralysis: Motor dysfunction of the upper limbs caused by trauma, neurodegenerative diseases (such as Parkinson's disease, amyotrophic lateral sclerosis), or congenital neuromuscular disorders (such as spinal muscular atrophy); 2.Comorbid severe systemic diseases: Comorbid with severe cardiovascular and cerebrovascular diseases (such as uncontrolled hypertension, coronary heart disease, epilepsy), mental disorders (such as depression, schizophrenia); 3.Previous BCI-related interventions: Before participating in this study for the first time, they had already received rehabilitation training based on motor imagery using brain-computer interfaces. 4.Skin or body surface contraindications: If the skin on the affected upper limb is damaged, inflamed, or has metal implants (such as internal fixation for fractures), it may interfere with the attachment of EEG electrodes or the safety of TMS stimulation; 5.Epilepsy risk: History of previous epileptic seizures or new-onset epilepsy after stroke, and no regular antiepileptic drug treatment; 6.Drug interference: Currently taking antiepileptic drugs (such as benzodiazepines), sedatives (such as benzodiazepines, barbiturates); 7.Contraindications for TMS: presence of intracranial metal implants, such as cardiac pacemakers or intracranial electrodes; 8.Currently receiving other neuromodulation techniques, such as tDCS,
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Fugl-Meyer (upper extremity) assessment scale; | — |
Secondary
| Measure | Time frame |
|---|---|
| Modified Barthel Index;Wolf?motor function test;Accuracy of task completion; | — |
Countries
China
Contacts
Public ContactLingjing Jin
Shanghai Yangzhi rehabilitation hospital
Outcome results
None listed