Stroke
Conditions
Brief summary
High definition tDCS will be conducted to both stroke and healthy subjects on primary motor cortex area to explore the motor excitability changes before and after stimulation. In next stage, a randomized control trial with 20-session training will be conducted to evaluate the effectiveness of transient modulation of cortical excitability through multisite HD-tDCS with EMG driven robot hand training, a sham stimulation with EMG-driven robot hand training will be applied as control group.
Interventions
DEVICEHD-tDCS
Different stimulation protocols will be applied to the primary motor cortex of stroke patients. After 20-minute stimulation, EMG-driven robot hand training will be conducted.
Sponsors
Chinese University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Sufficient cognition to follow simple instructions, as well as understand the content and purpose of the experiment; 2. Have moderate to severe motor disability at the paretic upper limb (assessed by Fugl-Meter Assessment (FMA), and Action Research Arm Test (ARAT)); 3. Hemiparesis resulting from a single unilateral lesion of the brain with onset at least 6 months before data collection
Exclusion criteria
1. Severe hand spasticity, open hand wound or hand deformity; 2. Visual field deficits; 3. Aphasia, neglect, and apraxia; 4. History of alcohol, drug abuse or epilepsy; 5. Bilateral infracts; 6. Uncontrolled medical problems; 7. Serious cognitive deficits \[Mini-Mental State Examination (MMSE) \< 21\]; 8. Major depression 9. Metal implants inside body 10. MRI, TMS and tDCS contraindications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Electroencephalography (EEG) and Electromyography (EMG) | Before intervention, During intervention, After intervention, 6-month after intervention | It is used to investigate the changes in corticomuscular coherence for studying connectivity between the brainwave using EEG and the affected hand muscles using EMG. In addition, EMG will be used to detect muscle activation change and muscle co-contraction pattern alteration. |
| Action Research Arm Test (ARAT) | Before intervention, After intervention, 6-month after intervention | The ARAT is a 19-item measure divided into 4 sub-tests (grasp, grip, pinch, and gross arm movement) to assess upper limb functioning |
| Fugl-Meyer Assessment Upper Extremity (FMA-UE) | Before intervention, After intervention, 6-month after intervention | It is used to evaluate and measure upper-limb recovery in post-stroke hemiplegic patients, and items are scored on a 3-point ordinal scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Magnetic Resonance Imaging (MRI) | Before intervention, After intervention, 6-month after intervention | It is used to identify neural correlates of stimulation-induced behavioral gains for investigating tDCS-induced changes in brain activations |
| Transcranial Magnetic Stimulation (TMS) | Before intervention | It is used to measure the changes in interhemispheric imbalance and corticospinal excitability |
Countries
Hong Kong
Contacts
Primary ContactRaymond Kai-yu Tong, PhD
Outcome results
None listed