Effect of Transcranial Magnetic Stimulation on Recovery of Upper Limb Among Stroke Survivors
Primary Purpose
Stroke
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Transcranial magnetic stimulation (TMS)
Sponsored by

About this trial
This is an interventional treatment trial for Stroke focused on measuring stroke, transcranial magnetic stimulation, rehabilitation
Eligibility Criteria
Inclusion Criteria:
--≥18 years of age
- Ability to give informed consent
- An unilateral ischemic stroke of onset 6-36 months prior to the study
- No other known brain abnormalities by medical history or by MRI
- Affected upper limb function of score 2-6 in Chedoke Arm and Hand Inventory
- Enrolled or planned to be enrolled in occupational therapy at Kessler Institute for Rehabilitation as an outpatient
Exclusion Criteria:
- More than one stroke (Transient Ischemic Attack not a reason for exclusion) Neurological conditions other than stroke (brain tumor, Parkinson's disease, etc)
- History of epilepsy or unprovoked seizures
- Family history of epilepsy (father, mother, children, siblings with diagnosis of epilepsy)
- Implanted medical devices (pacemakers, defibrillators, medical pump, implanted brain stimulator, aneurysm clip, carotid or cerebral stents, central venous catheter, cochlear implant, internal hearing aids)
- Damaged skin or skull of head
- Excessive spasticity of upper limb as indicated by Modified Ashworth Spasticity Scale >2/4
- Recent injection of antispastic medications (Botulinum toxin, phenol) of the last 3 months or scheduled such injection during the study period
- Severe sensory deficits as measured by a score of 2 on item 8 of the National Institute of Health (NIH) stroke scale
- Severe aphasia as measured by a score of ≥2 on item 9 of NIH stroke scale
- Being determined to be medically unstable by a physician
- Being pregnant or trying to become pregnant
- Past or current alcohol abuse, illicit drug use, or significant mental illness (schizophrenia, major depression, manic disorders)
- Working with metal currently or in the past
- Tattoo with metal based ink on the head or neck
- Unable to answer the questionnaires in the consent form correctly
Sites / Locations
- Kessler Foundation
Arms of the Study
Arm 1
Arm 2
Arm Type
Sham Comparator
Experimental
Arm Label
Sham stimulation
transcranial magnetic stimulation
Arm Description
Sham stimulation on the scalp of unaffected brain
transcranial magnetic stimulation on unaffected brain
Outcomes
Primary Outcome Measures
Upper limb function (Fugl Meyer score)
Secondary Outcome Measures
Full Information
NCT ID
NCT01938690
First Posted
September 5, 2013
Last Updated
February 16, 2021
Sponsor
Kessler Foundation
1. Study Identification
Unique Protocol Identification Number
NCT01938690
Brief Title
Effect of Transcranial Magnetic Stimulation on Recovery of Upper Limb Among Stroke Survivors
Official Title
Effect of Transcranial Magnetic Stimulation on Motor Recovery of Upper Limb Among Stroke Survivors: Pilot Study
Study Type
Interventional
2. Study Status
Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
February 2013 (undefined)
Primary Completion Date
September 2013 (Actual)
Study Completion Date
December 2013 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Kessler Foundation
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Approximately two thirds of stroke survivors have profoundly impaired function of the upper limb. Currently the main stay of the treatment for upper limb motor function is rehabilitation therapy focusing on repetitive and skillful task practice (task-oriented therapy) which has been shown to induce substantial functional reorganization in the undamaged motor cortex and functional recovery. In spite of rehabilitation therapy, functional recovery of arm and hand function is limited to one third of stroke survivors and there is a great need for adjunct treatment to current practice. Repetitive Transcranial Magnetic Stimulation (rTMS) is a noninvasive means of stimulating nerve cells in superficial areas of the brain and emerging as a novel method of modulating cortical excitability and promoting functional recovery after stroke. There have been studies using rTMS to improve motor function after stroke. However, whether 1Hz rTMS can enhance the effect of the task-oriented therapy on upper limb function after stroke has not been investigated. In this pilot proposal, we intend to investigate the feasibility of 1Hz rTMS on unaffected hemisphere as an adjunct to task-oriented therapy to improve upper limb motor function among stroke patients. The information obtained from this pilot study will provide a platform for the future randomized control trials combining the rTMS and task-oriented therapy to enhance motor recovery among stroke survivors.
Detailed Description
See above.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stroke
Keywords
stroke, transcranial magnetic stimulation, rehabilitation
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
12 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Sham stimulation
Arm Type
Sham Comparator
Arm Description
Sham stimulation on the scalp of unaffected brain
Arm Title
transcranial magnetic stimulation
Arm Type
Experimental
Arm Description
transcranial magnetic stimulation on unaffected brain
Intervention Type
Device
Intervention Name(s)
Transcranial magnetic stimulation (TMS)
Intervention Description
8 sessions of TMS followed by task specific training
Primary Outcome Measure Information:
Title
Upper limb function (Fugl Meyer score)
Time Frame
6 months
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
--≥18 years of age
Ability to give informed consent
An unilateral ischemic stroke of onset 6-36 months prior to the study
No other known brain abnormalities by medical history or by MRI
Affected upper limb function of score 2-6 in Chedoke Arm and Hand Inventory
Enrolled or planned to be enrolled in occupational therapy at Kessler Institute for Rehabilitation as an outpatient
Exclusion Criteria:
More than one stroke (Transient Ischemic Attack not a reason for exclusion) Neurological conditions other than stroke (brain tumor, Parkinson's disease, etc)
History of epilepsy or unprovoked seizures
Family history of epilepsy (father, mother, children, siblings with diagnosis of epilepsy)
Implanted medical devices (pacemakers, defibrillators, medical pump, implanted brain stimulator, aneurysm clip, carotid or cerebral stents, central venous catheter, cochlear implant, internal hearing aids)
Damaged skin or skull of head
Excessive spasticity of upper limb as indicated by Modified Ashworth Spasticity Scale >2/4
Recent injection of antispastic medications (Botulinum toxin, phenol) of the last 3 months or scheduled such injection during the study period
Severe sensory deficits as measured by a score of 2 on item 8 of the National Institute of Health (NIH) stroke scale
Severe aphasia as measured by a score of ≥2 on item 9 of NIH stroke scale
Being determined to be medically unstable by a physician
Being pregnant or trying to become pregnant
Past or current alcohol abuse, illicit drug use, or significant mental illness (schizophrenia, major depression, manic disorders)
Working with metal currently or in the past
Tattoo with metal based ink on the head or neck
Unable to answer the questionnaires in the consent form correctly
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
A.M. Barrett, MD
Organizational Affiliation
Kessler Foundation
Official's Role
Study Director
Facility Information:
Facility Name
Kessler Foundation
City
West Orange
State/Province
New Jersey
ZIP/Postal Code
07052
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Effect of Transcranial Magnetic Stimulation on Recovery of Upper Limb Among Stroke Survivors
We'll reach out to this number within 24 hrs