RecruitingNot ApplicableNCT05766059

Novel Non-invasive Brain Stimulation Techniques in Neurological Rehabilitation

Novel Non-invasive Brain Stimulation Techniques in Neurological Rehabilitation: Cross-modal Paired Associative Stimulation (PAS) Protocols to Promote Plastic Reorganization in Stroke and Phantom Limb Pain Patients


Sponsor

Istituto Auxologico Italiano

Enrollment

36 participants

Start Date

Feb 8, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

Paired associative stimulation (PAS) is a non-invasive brain stimulation protocol, where two stimuli (a peripheral and a cortical one, the latter delivered with transcranial magnetic stimulation - TMS) are repeatedly associated to enhance plasticity in the brain. In the present study, a new cross-modal, visuo-motor PAS protocol - called "mirror-PAS"- will be tested as a possible non-invasive brain stimulation treatment in neurological rehabilitation to promote motor recovery and pain reduction. Participants will perform the standard PAS targeting the motor system and the recently developed mirror-PAS in two separate sessions. The investigators will compare the possible effect of the protocols in terms of neurophysiological and behavioral outcomes to identify the optimal PAS method to enhance plasticity and promote sensory-motor function.


Eligibility

Min Age: 18 YearsMax Age: 85 Years

Inclusion Criteria8

  • age from 18 to 85 years
  • single, unilateral, hemispheric stroke (cortical or sub-cortical areas)
  • stroke confirmed by neuroimaging (CT or MRI)
  • stroke at least 4 months before enrollment
  • hemiparesis of the upper limb resulting from stroke or hemianesthesia clinically documented
  • age from 18 to 90 years
  • amputation of one part of the upper limb at least 2 months before enrollment
  • presence of stable phantom limb pain at least 2 months prior to enrollment

Exclusion Criteria5

  • contraindications to TMS (Rossi et all, 2021)
  • other neurological conditions (e.g., Parkinson's Disease, Multiple Sclerosis, ALS)
  • other orthopedic condition that affected the hand (e.g., carpal tunnel syndrome)
  • contraindications to TMS (Rossi et all, 2021)
  • other neurological, orthopedical or psychiatric conditions

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Interventions

DEVICETranscranial Magnetic Stimulation

The standard PAS protocol will be compared with the mirrorPAS protocol.


Locations(1)

Istituto Auxologico Italiano IRCCS

Milan, Lombardy, Italy

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NCT05766059


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