Changing brain rhythms to help hand movement after stroke
Modulation of Beta Oscillatory Rhythms in Stroke to Promote Corticomuscular Circuit Function
NA · University of North Carolina, Chapel Hill · NCT07121582
This study will test whether short sessions of non-invasive brain stimulation to either the motor or visual brain can strengthen brain-to-muscle signals and improve hand-squeezing performance in people with chronic stroke and hand weakness.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 20 (estimated) |
| Ages | 45 Years to 80 Years |
| Sex | All |
| Sponsor | University of North Carolina, Chapel Hill (other) |
| Locations | 1 site (Chapel Hill, North Carolina) |
| Trial ID | NCT07121582 on ClinicalTrials.gov |
What this trial studies
In this randomized crossover pilot, 20 people with chronic (≥6 months) unilateral stroke will complete a single ~3-hour visit during which investigators record brain activity with EEG and muscle activity with EMG while participants perform a precision grip task. Participants will receive two types of beta-burst repetitive transcranial magnetic stimulation (rTMS): one targeted to the ipsilesional motor hotspot (active) and one to the ipsilesional occipital cortex (control), with order randomized. Each participant performs three blocks (total 60 trials) of an isometric grip task before and after each stimulation condition, and investigators will measure corticomuscular coherence (CMC) in the beta band (13–30 Hz) as the primary physiologic outcome. The protocol is designed to test whether enhancing beta-range oscillations can strengthen functional connectivity between cortex and affected hand muscles.
Who should consider this trial
Good fit: Adults with chronic (≥6 months) unilateral ischemic or hemorrhagic stroke who have contralateral upper-extremity weakness, an ipsilesional motor-evoked potential, MoCA ≥21, English proficiency, and the ability to perform an isometric grip task are ideal candidates.
Not a fit: People with recent stroke (<6 months), significant cognitive impairment (MoCA <21), contraindications to TMS (recent seizures, pregnancy, indwelling metal), severe vision loss, concurrent stroke therapy or other arm-limiting conditions are unlikely to benefit or may be ineligible.
Why it matters
Potential benefit: If successful, the approach could strengthen brain–muscle communication and point to a non-invasive way to improve hand control after stroke.
How similar studies have performed: Prior small studies and experimental work have shown that rTMS and modulation of beta rhythms can influence motor circuits, but using beta-burst rTMS specifically to boost corticomuscular coherence after stroke remains experimental.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Chronic (≥ 6 months) unilateral cortical/subcortical ischemic or hemorrhagic stroke as confirmed by medical records * Upper extremity weakness (hemiparesis) contralateral to the stroke * Sufficient cognitive capacity (Montreal Cognitive Assessment ≥ 21 points), communication function, and English proficiency to understand and safely comply with all study procedures * Ipsilesional motor-evoked potential response * Able to perform isometric grip task by making a fist with their stroke-affected hand (hand contralateral to the stroke) Exclusion Criteria: * Contraindications to TMS (seizure activity within past 2 years, pregnancy, indwelling metal) * Cognitive deficits (Montreal Cognitive Assessment \< 21 points) * Concurrent physical/occupational therapy and/or clinical trial participation related to stroke * Injury or conditions that impact affected extremity-use beyond stroke (e.g., arthritis) * Impaired vision despite use of aid (e.g. glasses, contacts, etc.) * Cerebellar stroke * Major medical/neurological/psychiatric condition impacting physical function in the opinion of the physician co-investigator * Absent ipsilesional motor-evoked potential response
Where this trial is running
Chapel Hill, North Carolina
- Bondurant Hall — Chapel Hill, North Carolina, United States (RECRUITING)
Study contacts
- Principal investigator: Jessica M Cassidy, DPT, PT, PhD — University of North Carolina, Chapel Hill
- Study coordinator: Jessica M Cassidy, DPT, PT, PhD
- Email: CassidyLab@unc.edu
- Phone: 919-966-8404
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Stroke, stroke, neurostimulation, brain, motor, hand, electroencephalography