Spinal Plasticity to Reduce Hand Impairment After Stroke

Status Completed

Clinical Trial Summary

The purpose of the study is to induce plasticity in corticospinal-motoneuronal synapses serving an intrinsic hand muscle of the hemiparetic limb in humans with stroke. Neurologically-intact controls are included to verify that an effect was present in absence of stroke. Outcome measures in controls also provide a reference point that help us to understand the size of the effect and mechanisms mediating the effect in the neurologically-intact system.

Clinical Trial Description

Stroke is a leading cause of serious long-term disability in the United States with 795,000 individuals suffering a new or recurrent stroke each year. In most cases, disability is associated with incomplete motor recovery of the paretic limb. Even with intensive therapy, full recovery is often not achieved. Thus, there is a need for mechanistic approaches that drive the impaired neuronal targets of retraining to fully harness the corticospinal system's adaptive capacity. The goals of this study are to leverage principles of spike timing-dependent plasticity (STDP) via non-invasive stimulation techniques to strengthen corticospinal transmission. Few studies have targeted the cortex after stroke in humans, and none have targeted the corticospinal-motoneuronal synapse in the spinal cord. This study, therefore, is a novel approach to studying neuroplasticity after stroke. Previous work in humans with incomplete spinal cord injury demonstrates that the resulting plasticity transiently enhances motor output, indicating that there is also therapeutic potential. This study will attempt to induce bi-directional STDP in corticospinal-motoneuronal synapses serving an intrinsic hand muscle of the hemiparetic limb. Control experiments will be completed to provide evidence of the neurophysiological mechanism(s) mediating the effect and to examine behavioral effects. Individuals who are at least 6 months post first-ever subcortical stroke and have at least partial range of motion of the paretic index finger will be recruited to participate. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT03639116
Study type	Interventional
Source	University of Pittsburgh
Contact
Status	Completed
Phase	N/A
Start date	February 28, 2017
Completion date	April 24, 2020

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See also
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Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.