This trial is evaluating whether Phase-dependent paired corticomotoneuronal stimulation (PCMS) will improve 2 primary outcomes and 2 secondary outcomes in patients with Stroke. Measurement will happen over the course of up to 1 hour after intervention.
This trial requires 45 total participants across 4 different treatment groups
This trial involves 4 different treatments. Phase-dependent Paired Corticomotoneuronal Stimulation (PCMS) is the primary treatment being studied. Participants will be divided into 2 treatment groups. There is no placebo group. The treatments being tested are in Phase 1 & 2 and have already been tested with other people.
Stable ischemic lesions usually do not result in an improvement. Furthermore, after successful fibrinolysis in ischemic-like emboli, the rate of recurrent strokes is not higher than in asymptomatic patients after a matched follow-up period. Therefore, the view persists to consider the embolic mechanism in acute stroke.
Atherosclerosis, hypertension and diabetes are major causes of stroke. Some strokes such as subarachnoid hemorrhage occur when there is no atherosclerotic plaques in the blood vessels of the brain. This process is known as a'small arterial dissection'. Other strokes such as ischaemic strokes occur when there is a disruption in blood flow through normal arteries in the brain. Ischaemic stroke is sometimes triggered by major depressive disorders. Other less common causes of stroke include aortic aneurysm, carotid arteries or other cerebral aneurysms, intracerebral haemorrhage (during a migraine) and acute systemic inflammatory diseases. Stroke is more common in older people.
If the national hospital discharge and clinical database are to be believed, there is a considerable variation in the absolute and relative frequency of stroke among populations in each state in the United States. This suggests that stroke is not a uniformly distributed condition, although stroke incidence rate may vary among populations because of age-related factors not readily amenable to modification.
Stroke is the cause of serious injury and death of about 4.2 million people from around the world each year. It is the most common cause of motor incoordination and a major cause of hemiparesis. It kills a half of those affected each year. Patients with stroke may go on to have a second stroke in 12-13 per cent of cases (first stroke), or die later in one in three cases (first and recurrent). Approximately two thirds of patients living with disability in the United Kingdom have a stroke and nearly 80% of patients would be unable to walk without aid. Patients with stroke have poorer control of bladder and bowel functioning, are more likely to incur long-term side effects and have a worse quality of life.
Although stroke survivors have a high prevalence of comorbidities, only 13% of patients received guideline-recommended medications after their cerebral infarction. Most received aspirin. Patients who underwent coronary artery bypass surgery were less likely to receive anticoagulants than the general stroke population.
Families with stroke have a higher incidence of stroke than the general population. The increased number of strokes in the family members is, however, not associated with early stroke onset. Furthermore, early stroke onset increases with the number of strokes in the family.
For adults the age of onset is typically between ages of 55 to 66, but can be as young as 43. Females are twice as likely as males to get a stroke at age 40, and people with high blood pressure are twice as likely to have a stroke at age 74. Stroke is more common in colder and wetter summers; more common in warmer and drier summers. People who smoke are 60 times more likely to sustain a stroke.
The present review describes a novel method for the stimulation of motor units in the paretic quadrant at different excitability levels, as well as the clinical relevance of these findings. Results from a recent clinical trial show a significant enhancement of motor function as well as an increase in the number of active motor units in the paretic quadrant through the use of PCMS. Results from a recent clinical trial is expected to enhance our understanding of the mechanisms governing the improvement of recovery of motor function following stroke and provide a platform for further therapeutic investigations.
The common side effects of pcms include headache, [migraine](https://www.withpower.com/clinical-trials/migraine), nausea, vomiting, sweating, heart rate, blood pressure, and skin rash. For a long periods of time, these side effects are limited and can be managed adequately.
Paired cortical stimulation results in long-term potentiation (LTP). Paired cortical stimulation results in synchronisation of the motor cortex and the lower motor neuron, and facilitates motor learning.
There have been only a few new developments in treating stroke but they have had a lot of focus on developing a drug with the capability to deliver the same or better results without triggering as many adverse events as the currently used drugs do. More research needs to be done in order to discover these kinds of drugs. In the immediate future however, research on natural plant products or other natural products may have the best possibility of becoming available in the medium-to-long-term future for treatment of stroke.