Spastic Hemiparesis, Stroke Hemorrhagic, Stroke, Ischemic
Conditions
Keywords
Ischemic stroke, Hemorrhagic stroke, Spastic hemiparesis
Brief summary
The purpose of this study is to evaluate the limb functional improvement after contralateral C7 root transfer in stroke patients.
Detailed description
Spastic limb paresis after stroke is a cause of long-term disability and reduction is quality of life, with loss of hand dexterity being especially prohibitive. In the recovery phase after initial injury, neural reorganization occurs and has been observed in both ipsilateral and contralateral hemispheres. Previous studies have identified contralesional (opposite to the side of the injury), in other words, ipsilateral, activation in the recovery of paretic hand function. However, this pathway of recovery is limited due to sparse connections between the ipsilateral hemisphere and the affected arm/hand. By establishing an anatomic connection between the ipsilateral hemisphere and the paretic arm with contralateral nerve transfer, compensatory capacity of the ipsilateral hemisphere is facilitated. This cross neck C7-C7 root transfer is an established procedure for the treatment of brachial plexus injuries and recently, for the treatment of spastic arm paresis in those with cerebral injury.
Interventions
PROCEDUREContralateral C7 root transfer for the treatment of spastic hemiparesis.
Performing surgery to transfer the C7 nerve to treat stroke patients experiencing spastic hemiparesis.
Sponsors
Dartmouth-Hitchcock Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* History of ischemic or hemorrhagic stroke with resultant arm paresis that has ceased to improve within 1-5 years of rehabilitation. * baseline Fugl-Meyer score below 33
Exclusion criteria
* pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in arm function, as measured by the Fugl-Meyer upper-extremity scale. | 12 months with visits at baseline and months 2, 4, 8, and 12 months after surgery. | The Fugl-Meyer is a widely used and highly recommended stroke-specific, performance-based measure of impairment with 5 domains and a possible 226 points. |
Countries
United States
Contacts
CONTACTLauren Sinks
PRINCIPAL_INVESTIGATORJennifer Hong, Dr.
Dartmouth-Hitchcock Medical Center
Outcome results
None listed