Accelerated rTMS for Post-Stroke Apathy
Apathy, Stroke Sequelae, Stroke (CVA) or TIA
About this trial
This is an interventional device feasibility trial for Apathy
Eligibility Criteria
Inclusion Criteria: 40 years old or greater Right- or left-hemisphere ischemic or hemorrhagic stroke with at least 6 months chronicity Symptomatic apathy as confirmed by (A) total score on the Apathy Evaluation Scale (AES)27 of ≥39 or (B) affirmative responses to three or more out of five general apathy screening questions Intact cortex under the coil at the stimulation target site confirmed by neuroimaging Ability to participate in psychometric testing and cognitive tasks Exclusion Criteria: Extra-axial hemorrhage Concomitant neurological disorders affecting motor or cognitive function (e.g. dementia) Moderate or severe global aphasia Visual impairment precluding completion of cognitive tasks Presence of contraindications to MRI or TMS including electrically, magnetically or mechanically activated metal or nonmetal implants such as cardiac pacemakers, intracerebral vascular clips, or any other electrically sensitive support system; Pregnancy (to be later confirmed by UPT in any premenopausal female participants) History of a seizure disorder Preexisting scalp lesion, wound, bone defect, or hemicraniectomy Claustrophobia precluding the ability to undergo an MRI Active substance use disorder Psychotic disorders Bipolar 1 Disorder Acute suicidality as assessed by the Columbia Suicide Severity Rating Scale (C-SSRS) or suicide attempt in the previous year
Sites / Locations
- Medical University of South Carolina Brain Stimulation Lab
Arms of the Study
Arm 1
Experimental
Repetitive transcranial magnetic stimulation
All participants will receive accelerated, high-dose repetitive transcranial magnetic stimulation (rTMS) at the medial prefrontal cortex (mPFC) delivered in runs of 600 pulses, twelve times per day, for three treatment days (contiguous or non-contiguous) within a seven-day period.