Please select the eligibility criteria that correspond to the clinical trial below.
Title: Efficacy Basics of Bihemispheric Motorcortex Stimulation After Stroke
Brief Summary: The aim of the study is to investigate whether the combination of bihemispheric ("dual") transcranial direct current stimulation (tDCS) and motor training on 5 consecutive days facilitates motor recovery in chronic stroke. Results will be compared to a matched group of patients undergoing anodal tDCS as well as a control group receiving sham tDCS. Functional and structural magnetic resonance imaging (MRI) before/after the intervention and during a 3 month follow-up will help investigating neural correlates of expected changes in motor function of the affected upper extremity.


Options:
A: Inclusion Criteria:

* Males and females subjects. Age \> 18 years.
* Diagnosis of first ischemic stroke
* Impairment of the upper limb
* Trunk control defined in the Trunk-Control Test (TCT), with a score \> 50.

Exclusion Criteria:

* anyone who does not have adequate understanding of verbal or written information in Italian sufficient to complete any test
* Impaired cognitive functioning: score less than 24 on the Mini Mental Status Examination (MMSE)
* contraindications to single-pulse transcranial magnetic stimulation (TMS)(TMS will be used to measure cortical excitability): presence of a history of epilepsy, frequent headaches or neck pain, implantable devices (ventriculoperitoneal shunts, pacemakers, intrathecal pumps, intracranial metal implants)
* Contraindications to tDCS: intracranial metal implants that can be stimulated, incorrectly positioned or over-heated by the electric current
* Neurological or psychiatric pathology
* severe cardio-pulmonary, renal, hepatic diseases
* Pregnancy
B: Inclusion Criteria:

* chronic stroke (\>6 months after stroke)
* age: 18 to 80 years
* non-hemorrhagic or hemorrhagic stroke

Exclusion Criteria:

* more than 1 stroke
* severe alcohol disease or drug abuse, severe psychiatric disease like depression or psychosis
* severe cognitive deficits
* severe untreated medical conditions
* other neurologic diseases
* severe microangiopathy
* pregnancy
C: Inclusion Criteria:

* Ischemic or hemorrhagic stroke onset 3 - 9 weeks before the recruiting, confirmed by computed tomography or magnetic resonance imaging.
* Moderate to severe motor impairment of an upper limb, defined as a score between 7 - 42 on the Upper Limb Subscale of Fugl Meyer Assessment of Sensorimotor Recovery after stroke.
* Ability to provide written informed consent (patient ou legal representative)
* Ability to comply with the schedule of interventions and evaluations in the protocol.

Exclusion Criteria:

* Severe spasticity at the paretic elbow, wrist or fingers, defined as a score of \> 3 on the Modified Ashworth Spasticity Scale.
* Upper limb plegia
* Uncontrolled medical problems such as end-stage cancer or renal disease
* Pregnancy
* Seizures, except for a single seizure during the first week post stroke
* Pacemakers
* Other neurological disorders such as Parkinson's disease
* Psychiatric illness including severe depression
* Aphasia ou severe cognitive deficits that compromise comprehension of the experimental protocol or ability to provide consent.
* Hemineglect
* Drugs that interfere on cortical excitability, except for antidepressants
* Cerebellar lesions
D: Inclusion Criteria:

* Clinical diagnosis of stroke, presenting with hemiplegia
* Within 14 days of stroke onset
* Medically stable
* Able to...

  * tolerate daily therapy for a minimum of 30 minutes per session
  * sit for more than 5 seconds without support
  * understand and follow 1 stage commands

Exclusion Criteria:

* Previous stroke with residual impairments
* Other neurological diagnosis (e.g. Parkinsons Disease, Multiple Sclerosis)
* Clinically relevant pre-morbid disability levels

Answer: B