Cerebrovascular Accident Clinical Trial
Official title:
Role of the Intact Hemisphere in Recovery of Motor Function After Stroke
The purpose of this study is to better understand the role of the motor part of the brain in
the recovery of motor function after stroke. The motor deficits that follow a stroke are
compensated for over several months. It has been proposed that the ipsilateral motor cortex
mediates these recovery processes. The results of this study will provide fundamental
information on the role of ipsilateral M1 in recovery of motor function after chronic
stroke.
A general patient evaluation will determine the location of the lesion site and assess the
degree of impairment in motor and global cognitive functioning. An assessment of motor
function will also be performed. Patients will be divided into two groups: well and poorly
recovered. An MRI (magnetic resonance imaging) scan may also be done if one has not been
performed in the past 6 months.
Two main procedures will be performed: transcranial magnetic stimulation (TMS) and test of
motor performance. In the first procedure, a metal coil surrounded by a plastic mold will be
placed on the head and electrical current will be pulsed through it. The electrical muscle
activity will be recorded through these electrodes with a computer. The second procedure
involves a reaction time test. The task will consist of reacting to a visual stimulus by
performing a voluntary movement. TMS pulses will be given before each movement. This is done
to determine whether this type of stimulation interferes with reaction time, which would
indicated that it interferes with the brain centers executing the reaction to the visual
Go-signal.
Patients with single ischemic hemispheric lesions at least 12 months after the stroke who
initially had a severe paralysis of the arm will be recruited for the study. Healthy normal
volunteers will also be included in the study. A special effort will be made to increase the
participation of women and diverse racial groups.
It has been proposed that recovery of motor function of the paretic arm following stroke is mediated by the ipsilateral (intact) motor cortex (M1). This proposal has not been conclusively tested experimentally and represents an important question in stroke rehabilitation. In this protocol, we will study the behavioral consequences of transient inactivation of ipsilateral M1 on motor performance of the affected arm in chronic stroke patients with complete and incomplete motor recovery. The results from this study will provide fundamental information on the role of ipsilateral M1 in recovery of motor function after chronic stroke. ;
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