Post Stroke Motor Learning

Study Overview
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Brief Summary
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Noninvasive brain stimulations (NIBS) will be used in chronic stroke patients to improve motor learning. Functional magnetic resonance imaging will be used to evaluate the mechanisms underlying motor learning in healthy volunteers and in chronic stroke patients.

Detailed Description
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transcranial direct current stimulation will be used for NIBS

Official Title
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Post-stroke Procedural Learning: From Neural Substrates to Therapeutic Modulation by Non-invasive Brain Stimulation

Conditions
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Stroke, Hemiparesis

Intervention / Treatment
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* Device: transcranial direct current stimulation tDCS
* Device: transcranial magnetic stimulation TMS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: stroke with at least slight deficit Exclusion Criteria: epilepsy contraindication to tDCS and/or to fMRI presence of metal in the head inability to understand / complete behavioral tasks chronic intake of alcohol or recreational drugs major health condition presence of pacemaker (for the fMRI part only) pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 95 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Real<br>Real tDCS | Device: transcranial direct current stimulation tDCS<br>* tdcs (ELDITH, Neuroconn, Ilmenau, Germany)<br>Device: transcranial magnetic stimulation TMS<br>* TMS (The Magstim Company Ltd, UK) Magstim 200² with a figure-of-eight coil was used to determine the hot spot eliciting consistent movements in the contralateral hand<br>|
| Placebo Comparator: sham<br>Sham tDCS | Device: transcranial direct current stimulation tDCS<br>* tdcs (ELDITH, Neuroconn, Ilmenau, Germany)<br>Device: transcranial magnetic stimulation TMS<br>* TMS (The Magstim Company Ltd, UK) Magstim 200² with a figure-of-eight coil was used to determine the hot spot eliciting consistent movements in the contralateral hand<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Motor learning improvement with tDCS | performance on a motor skill learning task and on different commonly used task (Purdue Pegboard, hand dynamometer, pinch dynamometer, 9-HPT ,...) were measured to explore the impact of tDCS on these parameters | Improvement on motor learning were recorded from baseline to 4 weeks after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neuroimaging | Does cerebral mechanisms underlying motor learning differ from healthy subject to stroke patients? | before motor learning, during motor learning and after (immediately, 30,60min) motor learning (with or without tDCS) | 
| Neurophysiological outcome measure | measure of brain excitability and connectivity with TMS (single and paired pulse) | start of session 5min before motor learning, just at the end of the motor learning, after 30 min of motor learning, after 60 min of motor learning, Recall test at 1,2,3,4 weeks after the day of intervention (with or without tDCS) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke