Targeted Noninvasive Brain Stimulation (T-NIBS) for Improving Hand Dexterity in Stroke Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Stroke
- Sponsor
- Kessler Foundation
- Enrollment
- 7
- Locations
- 1
- Primary Endpoint
- Changes in the Nine-Hole Peg Test (NHPT) scores
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
This study will investigate the use of High-definition Transcranial Direct Current Stimulation (HD-tDCS) in the functional improvement of hand dexterity while performing music-assisted hand exercises.
Detailed Description
Stroke is a serious medical and health problem in the US, and most of the stroke patients suffer from upper-limb motor deficits including weakened hand dexterity. As upper-limb motor functions are crucial for most of the daily living activities, there is a need for effective intervention. The current therapeutic approaches involve intensive physical therapy training involving repetitive tasks which causes fatigue and lack of engagement in the patients. To address this issue, the investigators will investigate the combined use of individually targeted noninvasive brain stimulation (T-NIBS) using High-definition Transcranial Direct Current Stimulation (HD-tDCS) and music-assisted hand exercises using MusicGlove to modulate the neuroplasticity in the desired manner to observe functional changes in hand dexterity.
Investigators
Vikram Shenoy Handiru
Associate Research Scientist
Kessler Foundation
Eligibility Criteria
Inclusion Criteria
- •Aged between 18-75 years
- •Clinically diagnosed with hemiparetic stroke (weakness on one side - either left or right side of the body)
- •Have had a stroke for more than 6 months
- •Have weakness in moving the fingers of the affected hand
- •Able to understand and perform the instructions that are part of the tDCS-MusicGlove testing and intervention.
- •Willing and able to participate in and travel to Kessler Foundation for the screening session, MRI session, and tDCS-MusicGlove sessions.
- •Able to sit and be active for 1.5 hours during the session without cardiac, respiratory and/or pain disturbances as assessed during the screening visit.
- •Able to provide informed consent.
- •Medically stable and not planning for a major change in medications for at least 4 weeks
Exclusion Criteria
- •Unable to move the hand because of muscle stiffness (scoring 3 or more on the Ashworth scale)
- •Have lost the sensation of hand movement
- •Have a history of alcohol abuse and/or illicit drug use
- •Have a history of smoking within the past 5 years
- •Have a problem with the eyesight that would make it difficult to notice the changing instructions on a computer screen
- •Currently enrolled in another research study that might affect this research study
- •A history of epilepsy (including family members who are diagnosed with epilepsy)
- •An active history of migraine or chronic headache
- •A history of mental illness (e.g. schizophrenia, anxiety, depression, and PTSD)
- •Past or current history of treated ringing in the ears known as tinnitus or severe hearing problems
Outcomes
Primary Outcomes
Changes in the Nine-Hole Peg Test (NHPT) scores
Time Frame: baseline (at day 1), during testing visits (day 2 and day 3)- all within 2 weeks from the screening and consenting
NHPT is a secondary outcome measure of finger dexterity that can be used in stroke patients with upper extremity motor deficits. It is considered to be a reliable measure of hand dexterity and recommended for inclusion in NIH toolbox Assessment of Neurological and Behavioral Function. NHPT requires participants to repeatedly place nine pegs into nine holes, one at a time, as quickly as possible and then remove them from the holes. The total time needed to complete the task is then recorded.
Changes in the Dexterity and Speed Test (DAST) scores
Time Frame: baseline (at day 1), during testing visits (day 2 and day 3)- all within 2 weeks from the screening and consenting
DAST is exclusively developed for MusicGlove performance assessment and it is designed to evaluate how fast and accurately do the subjects respond to the sequence of music notes that continuously sped up.
Secondary Outcomes
- Changes in the Cortical Excitability using Motor Evoked Potentials (MEP)(baseline (at day 1), during testing visits (day 2 and day 3) - all within 2 weeks from the screening and consenting)