Utility of CC7 Transfer in Stroke Subtypes

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the limb functional improvement after contralateral C7 root transfer in stroke patients.

Detailed Description
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Spastic limb paresis after stroke is a cause of long-term disability and reduction is quality of life, with loss of hand dexterity being especially prohibitive. In the recovery phase after initial injury, neural reorganization occurs and has been observed in both ipsilateral and contralateral hemispheres. Previous studies have identified contralesional (opposite to the side of the injury), in other words, ipsilateral, activation in the recovery of paretic hand function. However, this pathway of recovery is limited due to sparse connections between the ipsilateral hemisphere and the affected arm/hand. By establishing an anatomic connection between the ipsilateral hemisphere and the paretic arm with contralateral nerve transfer, compensatory capacity of the ipsilateral hemisphere is facilitated. This cross neck C7-C7 root transfer is an established procedure for the treatment of brachial plexus injuries and recently, for the treatment of spastic arm paresis in those with cerebral injury.

Official Title
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Seventh Cervical Nerve Transfer for Spastic Arm Paresis: A Prospective Analysis of Efficacy in Ischemic vs. Hemorrhagic Stroke

Conditions
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Stroke, Ischemic, Stroke Hemorrhagic, Spastic Hemiparesis

Intervention / Treatment
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* Procedure: Contralateral C7 root transfer for the treatment of spastic hemiparesis.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: History of ischemic or hemorrhagic stroke with resultant arm paresis that has ceased to improve within 1-5 years of rehabilitation. Exclusion Criteria: pregnancy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Contralateral C7 root transfer for the treatment of spastic hemiparesis.<br>The C7 nerve root transfer will occur to the patients on this arm. | Procedure: Contralateral C7 root transfer for the treatment of spastic hemiparesis.<br>* Performing surgery to transfer the C7 nerve to treat stroke patients experiencing spastic hemiparesis.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in arm function, as measured by the Fugl-Meyer upper-extremity scale. | The Fugl-Meyer is a widely used and highly recommended stroke-speciﬁc, performance-based measure of impairment with 5 domains and a possible 226 points. | 12 months with visits at baseline and months 2, 4, 8, and 12 months after surgery. |