Healthy Clinical Trial
Official title:
Motor Learning: Behavioral and Physiologic Studies in Normal Volunteers and Stroke Patients
This study will try to elucidate learning processes associated with motor training in the
weak arm of stroke patients compared with healthy controls. Results from previous clinical
trials indicate that training may enhance motor function in healthy volunteers, and perhaps
also in stroke patients, even more than 1 year after the stroke. Normal, healthy volunteers
and stroke patients 18 years of age and older may be eligible for this study.
Study subjects will have a physical examination and participate in 6 additional clinic
visits-training and testing sessions on study days 1, 2, 3, 4 and 5, and a final testing
session on day 12. During these sessions, they will perform a series of motor tasks,
including writing, picking up objects, turning cards, stacking checkers and moving cans,
which will be timed and videotaped. Each session will be divided into blocks of 10 trials
for each task, separated by 2-minute rest periods.
Before and after training on days 1, 2, 5 and 12, subjects will have transcranial magnetic
stimulation (TMS) to determine brain changes associated with learning a motor task. For this
procedure, the patient is seated in a comfortable chair, and an insulated wire coil is
placed on the scalp or skin. A brief electrical current is passed through the coil, creating
a magnetic pulse that stimulates the brain. These pulses generate very small electrical
currents in the brain cortex, briefly disrupting the function of the brain cells in the
stimulated area. The stimulation may cause muscle twitching or tingling in the scalp, face,
or limb. During the stimulation, the subject may be asked to slightly tense certain muscles
or perform other simple actions.
Electrical nerve stimulation and electromyography will be done to record muscle responses to
stimulation. A nerve is stimulated by placing wires on the skin over the nerve and passing a
brief electrical current between the wires. Electromyography involves taping metal
electrodes to the skin over the muscle.
Before and after each session, subjects' muscle strength will be tested with a pinch gauge.
They will also be asked to make a mark on a line drawn on paper, to rate their test
performance and levels of attentiveness and fatigue.
The purpose of this protocol is to characterize dynamics of motor learning over a 5-day period in chronic stroke patients relative to healthy age-matched controls. Motor learning will be assessed by improvements in the Jebsen-Taylor test, a validated tool widely used in rehabilitation that measures upper extremity function. Additionally, we intend to evaluate changes in the excitability of the primary motor cortex associated with learning using transcranial magnetic stimulation. ;
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