rTMS Posterior Parietal Cortex Modulation and Upper Limb Movement After Stroke

University Hospital, Lille20 enrolled

Overview

This study evaluates the effect of a unique session of inhibitory rTMS (cTBS) over the contralesional posterio parietal cortex (PPC) on the spatio-temporal parameters of a pointing movement performed by stroke patients with their paretic upper limb. It will also assess the effects on the resting motor threshold of both hemispheres and on parietopremotor connectivity. To achieve theses aims, the real cTBS stimulation will be randomly counterbalanced with a SHAM stimulation (in a second session) in a crossover design. Assessments will be performed before and after each stimulation session.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

SINGLE

Enrollment

Conditions

Stroke Hemiparesis Transcranial Magnetic Stimulation Brain Connectivity

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 18 and 80y * Right-handed * Right hemispheric stroke confirmed by a 3D imaging technique * at the chronic phase (\>6months) * subject being able to perform a pointing movement of at least 20cm in the anterior space without compensatory movements of the trunk * informed consent * Social security affiliation Exclusion Criteria: * Severe comprehension troubles (language, cognitive or psychiatric disorders) * History of neurological disorders in addition to the stroke * Locomotor troubles affecting the paretic arm * Contraindication to rTMS : epilepsy, intracranial metallic foreign body, cochlear implant, unstable fracture of the skull bones, deafness * pregnancy or breastfeeding * adult subject to guardianship

Outcomes

Primary Outcomes

Time of movement during the pointing movement

Time between the initiation of the movement and the reaching of the target

Time frame: 30 minutes

Secondary Outcomes

Reaction time (time between the go signal and th onset of the movement)

temporal parameters of pointing movements

Time frame: 30 minutes

Response time (time between the go signal and the reaching of the target)

temporal parameters of pointing movements

Time frame: 30 minutes

Peak velocity of the hand during the pointing movement

pak velocity in m/s

Time frame: 30 minutes

smoothness (number of units of movement during the pointing movement),

Spatial parameters of pointing movements

Time frame: 30 minutes

Linearity (ration between the length of the trajectory of the hand and the linear distance between the initial position of the hand and the target)

Spatial parameters of pointing movements

Time frame: 30 minutes

Detection of mirror movements with the healthy upper limb

EMG detection

Time frame: 30 minutes

Primary motor cortex excitability of both motor cortices

Resting motor threshold of lesioned and non-lesioned hemispheres

Time frame: 30 minutes

Parietomotor connectivity in the contralesional hemisphere

Assessed by a paired-pulse TMS protocol (see Allart et al. 2017 for more details)

Time frame: 30 minutes

Spatial bias

Line bisection test

Time frame: 30 minutes

rTMS Posterior Parietal Cortex Modulation and Upper Limb Movement After Stroke

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts