Brain Lesion (General), Visuomotor Skills
Conditions
Keywords
visuomotor processing, electroencephalography (EEG), transcranial magnetic stimulation (TMS), eye-hand control
Brief summary
This pilot study aims at establishing personalized state-based rTMS for precision neurorehabilitation, we designed a within-subject cross-over study to test closed-loop repetitive transcranial magnetic stimulation and electroencephalography (rTMS-EEG) comparing the targeting of two key nodes in the frontoparietal network during bimanual visuomotor force tracking in persons with upper extremity sensorimotor impairment affecting eye-hand control.
Detailed description
There is a need for oscillatory or repetitive neuromodulatory tools and methods that are effective in entraining intrinsic neural rhythms to improve inefficient functional coupling within neural circuits. The goal of the proposed study is to develop a closed-loop application of repetitive transcranial magnetic stimulation (rTMS) and electroencephalography (EEG) suitable for use in multidomain precision neural-circuit based rehabilitation studies that permits the time-locked application of rTMS pulses to the phase of the intrinsic neural oscillation (personalized state-based application) in a defined behavioral context (e.g., goal-directed eye-hand control).
Interventions
DEVICErepetitive transcranial magnetic stimulation (rTMS)
rTMS will be applied time-locked to the intrinsic brain rhythms to individually-defined brain regions
Sponsors
Medical University of South Carolina
National Institutes of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adult volunteers (age ≥18 years) * right-hand dominance (defined with the Edinburg Handedness Scale) * voluntary whole-hand grip force (Medical Research Council scale for muscle force ≥2) * capable of repeated grasp and release with 5% of maximum voluntary contraction (standardized with an in-house computer-based assessment involving whole-hand grip force tracking upon visual cues with a digital dynamometer).
Exclusion criteria
* presence of any MRI risk factors (such as an electrically, magnetically, mechanically activated metal or nonmetal implant including cardiac pacemaker, intracerebral vascular clips, any other electrically sensitive support system, or claustrophobia) * presence of any contraindications to repetitive transcranial magnetic stimulation, rTMS (e.g., history of seizures or epileptic activity, currently taking medications that lower seizure thresholds) * any neurological or psychiatric disorders affecting cognitive function (e.g., established dementia) affecting the ability to understand the purpose of the study and give informed consent or ability to complete cognitive testing * substance use disorder * visual impairment that precludes completion of scanner tasks * uncontrolled hypertension despite treatment * intake of tricyclic anti-depressants * musculoskeletal disorders affecting bimanual grasp- and release * pregnancy (or suspected/possible pregnancy or plan to become pregnant in the short term). If the participant is a woman of childbearing potential, a urine pregnancy test will be performed on a standard basis. * severe aphasia affecting particularly of receptive nature (NIH Stroke Scale, NIHSS Language subsection ≥2) affecting the ability to understand the purpose of the study and give informed consent * pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of whole hand grip force precision | 90 minutes | Force time series will be used to extract two measures for each trial to describe distinct features of visuomotor force adjustment: 1) Root Mean Square Error (RMSE) to characterize the deviation of the actual force from the target force, i.e., over- and undershoot and 2) sample entropy (SmpEn) to quantify the randomness or uncertainty of the sampled force time series. From these measures, the trial-based relative changes in RMSE and SmpEn from baseline (before intervention) will be computed. |
| Change of functional brain connectivity. | 90 minutes | Trial-specific phase-based connectivity will be extracted from the electroencephalography (EEG) time series and computed relative to baseline (before intervention). |
Countries
United States
Contacts
CONTACTKirstin-Friederike Heise, PhD
PRINCIPAL_INVESTIGATORKirstin-Friederike Heise, Ph.D.
Medical University of South Carolina
Outcome results
None listed