Cerebral Stroke Clinical Trial
Official title:
Entwicklung Neuronaler Repräsentationen Nach Schlaganfall: Verbesserung Motorischer Leistungen Durch Transkranielle Gleichstromstimulation Und Noradrenerge Co-Stimulation
The hypothesis of the study is that combination of reboxetine/tDCS is more effective in enhancing motor functions of daily life (assessed by the Jebsen Taylor test) as compared to reboxetine and tDCS alone. The protocol is designed as a within-subject, block randomized placebo-controlled double-blind crossover study.
One important feature of the human brain is the ability to undergo plastic changes and
reorganization after learning and lesions of the nervous system. This ability is of major
importance for the treatment of functional deficits after stroke. Stroke is the major disease
leading to persistent functional disabilities in Germany. However, the success rate of
therapeutic interventions, especially in chronic stroke patients, is still unsatisfactory.
Thus, basic science is essential to discover new therapeutic options that bear the potential
for translation into clinical practice. Recent evidence is pointing to modulating the motor
cortical excitability in order to enhance motor function in stroke patients. For this
purpose, reboxetine as a selective reuptake inhibitor of noradrenaline and transcranial
direct current stimulation have proven effective in enhancing motor functions needed for
daily life activities by 10-12%. These improvements were significant compared to placebo, but
still clinically unsatisfactory. Thus, this protocol aims at enhancing the excitability
modulatory effect of each single intervention through the combination of reboxetine and tDCS.
The hypothesis of the study is that combination of reboxetine/tDCS is more effective in
enhancing motor functions of daily life (assessed by the Jebsen Taylor test) as compared to
reboxetine and tDCS alone.
The protocol is designed as a within-subject, block randomized placebo-controlled
double-blind crossover study. 12 chronic stroke patients with persistent functional deficits
of the arm and/or hand will be included. The primary outcome measure is the time needed to
fulfill all subtests of the Jebsen Taylor test. All patients undergo four different
conditions in four different sessions: 1) reboxetine + verum tDCS; 2) reboxetine + sham tDCS
3) placebo drug + verum tDCS 4) placebo drug + sham tDCS.
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