rTMS Posterior Parietal Cortex Modulation and Upper Limb Movement After Stroke

Not Applicable

• Conditions: Stroke; Brain Connectivity; Hemiparesis; Transcranial Magnetic Stimulation
• Interventions: Device: repeated transcranial magnetic stimulation continuous theta-burst stimulation; Device: SHAM repeated transcranial magnetic stimulation

• Registration Number: NCT03323255
• Lead Sponsor: University Hospital, Lille

Brief Summary

This study evaluates the effect of a unique session of inhibitory rTMS (cTBS) over the contralesional posterio parietal cortex (PPC) on the spatio-temporal parameters of a pointing movement performed by stroke patients with their paretic upper limb. It will also assess the effects on the resting motor threshold of both hemispheres and on parietopremotor connectivity.

To achieve theses aims, the real cTBS stimulation will be randomly counterbalanced with a SHAM stimulation (in a second session) in a crossover design. Assessments will be performed before and after each stimulation session.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2017-10-16
• Study First Submitted QC: 2017-10-23
• Study First Posted: 2017-10-26
• Status Verified: 2020-03
• Study Start: 2020-03-10
• Last Update Submitted: 2020-03-25
• Last Update Posted: 2020-03-26
• Primary Completion: 2020-08
• Study Completion: 2020-08

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• Age between 18 and 80y
• Right-handed
• Right hemispheric stroke confirmed by a 3D imaging technique
• at the chronic phase (>6months)
• subject being able to perform a pointing movement of at least 20cm in the anterior space without compensatory movements of the trunk
• informed consent
• Social security affiliation

Exclusion Criteria

• Severe comprehension troubles (language, cognitive or psychiatric disorders)
• History of neurological disorders in addition to the stroke
• Locomotor troubles affecting the paretic arm
• Contraindication to rTMS : epilepsy, intracranial metallic foreign body, cochlear implant, unstable fracture of the skull bones, deafness
• pregnancy or breastfeeding
• adult subject to guardianship

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
cTBS stimulation	repeated transcranial magnetic stimulation continuous theta-burst stimulation	continuous theta-burst TMS stimulation (1200 pulses, 50Hz, separated in two sequences of 600 pulses)
SHAM stimulation (placebo)	SHAM repeated transcranial magnetic stimulation	SHAM stimulation

Primary Outcome Measures

Name	Time	Method
Time of movement during the pointing movement	30 minutes	Time between the initiation of the movement and the reaching of the target

Secondary Outcome Measures

Name	Time	Method
Linearity (ration between the length of the trajectory of the hand and the linear distance between the initial position of the hand and the target)	30 minutes	Spatial parameters of pointing movements
Primary motor cortex excitability of both motor cortices	30 minutes	Resting motor threshold of lesioned and non-lesioned hemispheres
Response time (time between the go signal and the reaching of the target)	30 minutes	temporal parameters of pointing movements
Peak velocity of the hand during the pointing movement	30 minutes	pak velocity in m/s
smoothness (number of units of movement during the pointing movement),	30 minutes	Spatial parameters of pointing movements
Detection of mirror movements with the healthy upper limb	30 minutes	EMG detection
Reaction time (time between the go signal and th onset of the movement)	30 minutes	temporal parameters of pointing movements
Parietomotor connectivity in the contralesional hemisphere	30 minutes	Assessed by a paired-pulse TMS protocol (see Allart et al. 2017 for more details)
Spatial bias	30 minutes	Line bisection test

Trial Locations

Locations (1)

Hôpital Swynghedauw, CHU lille; 🇫🇷 Lille, France