Effects of Transcranial Direct Current Stimulation (tDCS) and Motor Learning in Children With Cerebral Palsy (CP)

Study Overview
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Brief Summary
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In this study, the investigators aim to assess the clinical and neurophysiological effects of a non-invasive brain stimulation technique - transcranial direct current stimulation (tDCS)- on cortical plasticity and motor learning in children with cerebral palsy. Investigators will use different assessment techniques, such as transcranial magnetic stimulation (TMS) and kinematics (sensors) to measure changes through the trial.

Official Title
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Effects of tDCS in Cortical Plasticity and Motor Learning in Children With Cerebral Palsy

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Device: Transcranial Direct Current Stimulation (tDCS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age of participants must be between 8 and 18 years old. Diagnosis of spastic or mixed CP with distribution of diplegia and/or hemiplegia form. Gross Motor Function Classification System for Cerebral Palsy (GMFCS) level II and III. Manual Ability Classification System for Children with CP (MACS) level II up to IV. Ability to cooperate and follow directions. Exclusion Criteria: Muscle tone reduction therapy in the past 3 months prior to study onset. Upper limb orthopedic surgery in the past 3 months prior to study onset. Any other form of therapy or procedure involving motor neuron junction inhibition; either by biochemical and/or mechanical denervation, in the past 3 months prior to study onset. History of convulsive disorder in the past 2 years prior to study onset. Current use of carbamazepine as anticonvulsive therapy. Presence ventriculoperitoneal shunt.

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Active tDCS<br>Subjects will receive active tDCS stimulation for 5 sessions (20m/each) over one week. | Device: Transcranial Direct Current Stimulation (tDCS)<br>* Subjects will receive tDCS stimulation 1x per day for 5 days (over the period of 1 week). Each session will be 20 minutes long. The subject will receive active stimulation for the entire 20 minutes.<br>* Other names: transcranial stimulation;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in motor assessments | Investigators will measure changes in kinematic (sensor) assessments from baseline to follow-up. The sensor will collect Inertial Measurements Units (IMU) and complex motion sensing, as measured by accelerometer/gyroscope/magnetometer of freedom motion capture. | Approximately 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in TMS measurements | Investigators will measure change in TMS measurements from baseline to follow-up. TMS measures will consist of: motor threshold, motor evoked potentials (MEP's), transcallosal inhibition, and examinations of intracortical inhibition and facilitation. | Approximately 2 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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motor learning, cortical plasticity, direct current stimulation