Rehabilitation, Spasticity, Muscle, Stroke
Conditions
Keywords
Stroke, Spasticity, Muscle, Rehabilitation, fNIRS, rTMS, Activation, Brain network
Brief summary
Stroke is of high morbidity and mortality, and surviving patients are often unable to take care of themselves because of severe motor dysfunction. The brain has plasticity, and makes adaptive changes after stroke, resulting in the reorganization and compensation of neural networks. However, the muscle tone of some patients will significantly increase during the recovery process, which affects the rehabilitation effect. Neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS) have been widely used to promote brain network remodeling after stroke. The investigators attempted to evaluate the motor brain network characteristics of spastic patients by fNIRS, and used the most active brain regions as rTMS stimulation regions to evaluate the improvement effect of this individualized treatment on post-stroke spasticity.
Interventions
PROCEDUREindividual rTMS based on fNIRS
The rTMS parameters will be set according to fNIRS results.
PROCEDURETraditional rTMS strategy
The low-frequency rTMS to contralesional M1 will always be used.
Sponsors
First Affiliated Hospital Xi'an Jiaotong University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to 79 Years
Healthy volunteers
Yes
Inclusion criteria
* Aged 40-79 years; * Patients with first-onset stroke within 1 to 3 months after onset; * Consciousness, sitting balance level 1 or above, can cooperate with fNIRS assessment; * The patient or its authorized agent signs the informed consent form.
Exclusion criteria
* Previous seizures; * Suffered from mental illness such as depression, anxiety, mania, and schizophrenia before the stroke onset; * Patients with metal on the head, cochlear implants, intracranial infections, etc. who are not suitable for rTMS.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| modified Ashworth scale | 1 month | The range is 0-Ⅳ level, the higher the level, the higher the spasticity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fugl-Meyer Assessment of upper limb motor function | 1 month | The score range is 0-66 points, the higher the score, the better the motor function of upper limb. |
| Barthel index | 1 month | The score range is 0-100 points, the higher the score, the better the activities of daily living. |
| average weighted clustering coefficient | 1 month | This is a brain network indicator based on graph theory. It is a measure of the local separation of the graph. The higher the average weighted clustering coefficient, the higher the degree of segregation of the brain network. |
| global efficiency | 1 month | This is a brain network indicator based on graph theory. It is a measure of the local integration of the graph. The higher the global efficiency, the stronger the ability of the network to transmit information. |
| inter-density | 1 month | It is a brain network indicator based on graph theory and is defined as the ratio of the actual number of connections among all possible connections between bilateral hemispheres. |
Countries
China
Contacts
Primary ContactZiwen Yuan, MD
Outcome results
None listed