Potentiation of Procedural Motor Learning in Health and Disease

Stroke Clinical Trial

Official title:

Potentiation of Procedural Motor Learning by Pharmacological Neuromodulation and Transcranial Direct Current Stimulation in Health and Disease

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT00126087
• Other study ID #: Motor-Neuromod_01
• Status: Terminated
• Phase: Phase 4
• First received: July 31, 2005
• Last updated: January 18, 2013
• Start date: July 2005
• Est. completion date: January 2013

Study information

• Verified date: January 2013
• Source: University Hospital Muenster
• Contact: n/a
• Is FDA regulated: No
• Health authority: Germany: Federal Institute for Drugs and Medical Devices
• Study type: Interventional

Clinical Trial Summary

The investigators plan to improve the learning of motor skills by pharmacological means (dopamine), and by noninvasive brain stimulation. They will study both healthy subjects and chronic stroke patients. In addition, they want to study the mechanisms of enhanced learning, on the molecular and the systems level.

Description:

Adaptive behavior requires procedural motor learning, i.e. the acquisition of motor skills. Procedural learning is particularly critical in the rehabilitation of chronic motor deficits after stroke. A potent modulator of motor function and learning is found in the endogenous dopaminergic system. The investigator's own work could demonstrate that formation of an elementary motor memory, which constitutes the first step in acquiring more complex motor skills, can be enhanced in both healthy subjects and chronic stroke patients by pre-medication with levodopa. The aim of the present proposal is to:

• expand these exciting findings to procedural motor learning;

• explore the interaction with age, brain lesions, add-on interventions such as transcranial direct current stimulation (tDCS); and

• illuminate the underlying mechanisms.

The effect of levodopa +/- tDCS on procedural motor learning and cortical excitability will be studied in healthy volunteers and stroke patients. Then the investigator plans to delineate the underlying mechanisms of this effect by exploring N-methyl-D-asparate (NMDA) receptor-dependency of levodopa-enhanced learning and changes in activation and connectivity (using functional magnetic resonance imaging) in the respective neural networks resulting from the interaction of learning and dopaminergic neuromodulation.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 18
• Est. completion date: January 2013
• Est. primary completion date: December 2007
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

Healthy Volunteers:

• Normal neurological examination

• Mini Mental State Examination of > 27

• Right handedness

Stroke Patients:

• Cortical or subcortical stroke with an initial severe hemiparesis Medical Research Council (MRC) scale < 2 that has recovered to a degree that patients are able to perform the proposed task (in general > MRC 4.5, with low spasticity, work in progress on motor learning in stroke patients)

• At least 1 year post-stroke

• Mini Mental State Examination of > 27

• Right-handedness

Exclusion Criteria:

Healthy Volunteers and Stroke Patients:

• No antipsychotic, antidepressant drugs, and drugs affecting the dopaminergic system.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Investigator, Outcomes Assessor), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Stroke

Intervention

Drug:
• dopamine

Locations

Country	Name	City	State
Germany	University of Münster, Department of Neurology	Münster	Nordrhein-Westfalen

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital Muenster

Country where clinical trial is conducted

Germany, 

References & Publications (2)

Flöel A, Breitenstein C, Hummel F, Celnik P, Gingert C, Sawaki L, Knecht S, Cohen LG. Dopaminergic influences on formation of a motor memory. Ann Neurol. 2005 Jul;58(1):121-30. — View Citation

Rösser N, Heuschmann P, Wersching H, Breitenstein C, Knecht S, Flöel A. Levodopa improves procedural motor learning in chronic stroke patients. Arch Phys Med Rehabil. 2008 Sep;89(9):1633-41. doi: 10.1016/j.apmr.2008.02.030. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Procedural motor learning (decrease in reaction time in ms) after the respective intervention (dopamine, transcranial direct current stimulation), compared to placebo