Motor Excitability Study of High Definition Transcranial Direct Current Stimulation (HD-tDCS) in Chronic Stroke

Chinese University of Hong Kong30 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Stroke

Interventions

HD-tDCSDEVICE

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.

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

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

Locations (1)

Department of Biomedical Engineering, The Chinese University of Hong Kong

Hong Kong, Hong Kong

RECRUITING

Outcomes

Primary Outcomes

Electroencephalography (EEG) and Electromyography (EMG)

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.

Time frame: Before intervention, During intervention, After intervention, 6-month after intervention

Action Research Arm Test (ARAT)

The ARAT is a 19-item measure divided into 4 sub-tests (grasp, grip, pinch, and gross arm movement) to assess upper limb functioning

Time frame: Before intervention, After intervention, 6-month after intervention

Fugl-Meyer Assessment Upper Extremity (FMA-UE)

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

Time frame: Before intervention, After intervention, 6-month after intervention

Secondary Outcomes

Magnetic Resonance Imaging (MRI)

It is used to identify neural correlates of stimulation-induced behavioral gains for investigating tDCS-induced changes in brain activations

Time frame: Before intervention, After intervention, 6-month after intervention

Transcranial Magnetic Stimulation (TMS)

It is used to measure the changes in interhemispheric imbalance and corticospinal excitability

Time frame: Before intervention

Central Contacts

Raymond Kai-yu Tong, PhD

CONTACT

+852 3943 8454 kytong@cuhk.edu.hk

Data from ClinicalTrials.gov

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