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TMS for Stroke Rehabilitation

CB
Overseen ByCathrin Buetefisch, 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?

This trial explores how repetitive transcranial magnetic stimulation (rTMS) can improve movement and brain function in individuals who have experienced a stroke affecting their motor skills. Participants will receive various types of rTMS to determine which method best enhances recovery and brain adaptability. This trial suits those who have had a single stroke impacting their primary motor system, have no other neurological diseases, and are not currently experiencing depression. As an unphased trial, it offers participants the chance to contribute to pioneering research that could enhance stroke recovery methods.

Do I need to stop my current medications for the trial?

The trial does not specify if you need to stop taking your current medications, but you cannot take any medication that lowers the seizure threshold.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that repetitive transcranial magnetic stimulation (rTMS) is generally safe and well-tolerated. Studies have found that both high and low-frequency rTMS do not cause serious side effects. People who have undergone this treatment often find it easy to handle.

This study focuses on specific brain areas: the opposite side of the premotor cortex, the opposite side of the primary motor cortex, and the same side of the premotor cortex. Research indicates that targeting these areas with rTMS can improve motor function without causing significant problems.

In past studies, participants usually experienced only mild side effects, if any. These might include a slight headache or discomfort where the stimulation is applied, but these effects are usually temporary. Overall, evidence suggests that rTMS is a safe option for those considering joining a clinical trial.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these TMS treatments for stroke rehabilitation because they offer a non-invasive approach to improving motor function. Unlike traditional rehabilitation methods that rely on physical therapy, these treatments use repetitive Transcranial Magnetic Stimulation (rTMS) to directly stimulate brain areas involved in movement. This technique targets specific brain regions, such as the contralateral and ipsilateral premotor cortex and the primary motor cortex, potentially enhancing neuroplasticity and speeding up recovery. The ability to precisely focus on different brain areas might offer more personalized and effective rehabilitation options compared to conventional therapies.

What evidence suggests that this trial's treatments could be effective for stroke rehabilitation?

Research has shown that repetitive transcranial magnetic stimulation (rTMS) can help stroke patients improve movement abilities. In this trial, participants will receive different types of rTMS. Some will have rTMS applied to the contralateral premotor cortex, which studies have found significantly enhances motor skills, especially in the arms. Others will receive rTMS over the contralateral primary motor cortex, improving hand function and reducing movement problems. Additionally, some participants will have rTMS applied to the ipsilateral premotor cortex, as evidence suggests this might aid recovery by reducing brain inhibition and boosting activity. Overall, rTMS shows promise for aiding stroke rehabilitation and improving movement.12467

Who Is on the Research Team?

CB

Cathrin Buetefisch, MD

Principal Investigator

Emory University

Are You a Good Fit for This Trial?

This trial is for stroke survivors aged 30-80, with a single ischemic infarction impacting the motor system. Participants must be able to consent, have no cognitive impairments or depression, and not suffer from other neurological diseases. They can't have contraindications to TMS like epilepsy, metal in the head/neck, implanted devices, history of migraines or take seizure-lowering meds.

Inclusion Criteria

I have never had seizures or epilepsy.
You do not have any reasons that would make transcranial magnetic stimulation (TMS) unsafe for you.
Ability to give informed, written consent
See 9 more

Exclusion Criteria

Not applicable.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive repetitive transcranial magnetic stimulation (rTMS) over the premotor cortex to improve motor performance

6 weeks
Weekly sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Repetitive TMS over contralateral premotor cortex
  • Repetitive TMS over contralateral primary motor cortex
  • Repetitive TMS over ipsilateral premotor cortex
  • Sham Repetitive TMS over contralateral premotor cortex
  • Single TMS over extensor carpi ulnaris spot of motor cortex
Trial Overview The study tests if repetitive transcranial magnetic stimulation (rTMS) on different parts of the brain improves motor function after a stroke. It involves various rTMS techniques over specific brain areas and sham treatments for comparison.
How Is the Trial Designed?
5Treatment groups
Experimental Treatment
Placebo Group
Group I: Single TMS over extensor carpi ulnaris spot of motor cortexExperimental Treatment1 Intervention
Group II: Repetitive TMS over ipsilateral premotor cortexExperimental Treatment1 Intervention
Group III: Repetitive TMS over contralateral primary motor cortexExperimental Treatment1 Intervention
Group IV: Repetitive TMS over contralateral premotor cortexExperimental Treatment1 Intervention
Group V: Sham repetitive TMS over contralateral premotor cortexPlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Emory University

Lead Sponsor

Trials
1,735
Recruited
2,605,000+

American Heart Association

Collaborator

Trials
352
Recruited
6,196,000+

Citations

Repetitive transcranial magnetic stimulation in stroke ...A meta-analysis of studies using LF-rTMS, HF-rTMS, and TBS for the recovery of the upper limb found a significant short- and long-term improvement in the ...
Effects of repetitive transcranial magnetic stimulation over the ...The effectiveness of repetitive transcranial magnetic stimulation (rTMS) as ischaemic stroke rehabilitation therapy has been thoroughly studied.
Repetitive transcranial magnetic stimulation for stroke ...In this review, the clinical benefits of rTMS for stroke rehabilitation are summarized, including improvements of motor impairment, dysphagia, depression, ...
Repetitive Transcranial Magnetic Stimulation of ...In conclusion, our results have demonstrated that rTMS over the contralesional M1 could lead to an improvement of motor function in the affected ...
Effects of Repetitive Transcranial Magnetic Stimulation on ...Our meta-analysis demonstrated that rTMS, when applied as an adjunct to conventional rehabilitation, significantly improved upper limb motor ...
Repetitive navigated transcranial magnetic stimulation to ...Repetitive TMS (rTMS) can up- or down-regulate cortical excitability; low-frequency rTMS can down-regulate the ipsilateral motor cortex and enhance the cortical ...
Repetitive transcranial magnetic stimulation for motor function ...This study aimed to systematically evaluate the safety and effectiveness of repetitive transcranial magnetic stimulation (rTMS) in treating motor dysfunction ...
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