Transcranial Direct Current Stimulation for Post-Stroke Motor Impairment

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SJ
Overseen BySanjiv Jain, MD
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

Non-invasive, non-pharmaceutical technologies that augment routine clinical practice for brain diseases and manage chronic symptoms have advanced rapidly over the past two decades. Among these, non-invasive brain stimulation such as transcranial direct current stimulation (tDCS) promotes neuroplasticity in injured brains, with fewer side effects and risks than invasive, implanted approaches such as deep-brain stimulation. Stimulating the brain can improve its function and help with recovery after a stroke. It has been a challenge to do this non-invasively. This is because the brain is reshaped after a stroke, and thus, it is difficult to find the right places to stimulate from the outside. In previous research, investigators found that optimal type and target of tDCS varied among subjects. The goal of this pilot trial is to test the feasibility of combining individually optimized, targeted high-definition tDCS (THD-tDCS) with rehabilitation therapy. Investigators will include 16 chronic stroke subjects with their optimal stimulation setup, obtained from their previous research. The participants will be computer-randomized into two equal-sized groups to receive either optimal THD-tDCS or sham stimulation, together with rehabilitation therapy (modified constraint-induced movement therapy, mCIMT) for five sessions over two weeks. Outcome measures will be collected at the baseline and right after the final intervention session. The primary outcome measure will be the change in the FM-UE score from baseline to immediately post the final intervention to assess the immediate effect of the intervention on upper extremity motor impairment. The secondary outcome measure will be the Wolf Motor Function Test time score to evaluate the immediate effect on functional motor performance.

Are You a Good Fit for This Trial?

This trial is for adults (18+) who have had a stroke causing weakness on one side of the body, with moderate to severe arm or hand movement problems. Participants must be able to consent and participate in English, have recent brain imaging from Carle, and not have severe muscle wasting, contractures, major sensory loss, or serious medical issues.

Inclusion Criteria

* Must have had either MRI or CT of the brain performed at Carle as part of their stroke care. Imaging may have been performed either during the diagnostic work-up for stroke or as follow-up after diagnosis. The most recent images from either MRI or CT will be collected for this study.
My arm function score is between 8 and 50 on the Fugl-Meyer scale.
I have significant weakness in my affected arm.
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Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either optimal THD-tDCS or sham stimulation with rehabilitation therapy for five sessions over two weeks

2 weeks
5 sessions (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • High-definition transcranial direct current stimulation (THD-tDCS)
  • Modified constraint-induced movement therapy (mCIMT)

Trial Overview

The study compares two groups: one receives personalized high-definition transcranial direct current stimulation (HD-tDCS) plus specialized rehab therapy for arm/hand recovery after stroke; the other gets sham (inactive) stimulation with the same rehab. Both groups get five sessions over two weeks.

How Is the Trial Designed?

2

Treatment groups

Active Control

Placebo Group

Group I: Optimal targeted HD-tDCS + mCIMTActive Control2 Interventions
Group II: Sham HD-tDCS + mCIMTPlacebo Group2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Carle Foundation Hospital

Lead Sponsor

Trials
7
Recruited
720+

American Heart Association

Collaborator

Trials
352
Recruited
6,196,000+