Clinical trial NCT03323255: rTMS Posterior Parietal Cortex Modulation and Upper Limb Movement After Stroke
Official title: Influence of the Modulation of the Posterior Parietal Cortex (rTMS) on a Pointing Movement With the Paretic Upper Limb After Stroke
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Stroke
Hemiparesis
Transcranial Magnetic Stimulation
Brain Connectivity
Lead sponsor: University Hospital, Lille
Sponsor class: OTHER
First posted: 2017-10-26
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: BASIC_SCIENCE

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.


Eligibility criteria: 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

Primary outcomes:
measure: Time of movement during the pointing movement
timeFrame: 30 minutes
Secondary outcomes:
measure: Reaction time (time between the go signal and th onset of the movement)
timeFrame: 30 minutes
measure: Response time (time between the go signal and the reaching of the target)
timeFrame: 30 minutes
measure: Peak velocity of the hand during the pointing movement
timeFrame: 30 minutes
measure: smoothness (number of units of movement during the pointing movement),
timeFrame: 30 minutes
measure: 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)
timeFrame: 30 minutes
measure: Detection of mirror movements with the healthy upper limb
timeFrame: 30 minutes
measure: Primary motor cortex excitability of both motor cortices
timeFrame: 30 minutes
measure: Parietomotor connectivity in the contralesional hemisphere
timeFrame: 30 minutes
measure: Spatial bias
timeFrame: 30 minutes
Other outcomes:
Locations:
city: Lille
country: France
facility: Hôpital Swynghedauw, CHU lille
Study officials:
affiliation: University Hospital, Lille
name: Etienne Allart, MD
role: PRINCIPAL_INVESTIGATOR
References: