Cerebellar rTMS to Improve Gait Recovery

NCT ID: NCT03456362

Last Updated: 2018-03-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-03-01

Study Completion Date

2017-10-01

Brief Summary

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The cerebellum is known to be strongly implicated in the functional reorganization of motor networks in stroke patients, especially for gait an balance functions. Repetitive transcranial magnetic stimulation of the cerebellum can be used to enhance these adaptive processes in stroke recovery. In this randomized, double blind, sham-controlled trial we aim to investigate the efficacy and safety of cerebellar intermittent theta burst stimulation coupled with intensive physical therapy in promoting gait recovery in hemiparetic patients due to recent stroke in the territory of the contralateral middle cerebral artery

Detailed Description

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Conditions

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Stroke Gait, Hemiplegic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Cerebellar iTBS

Intermittent theta burst stimulation applied immediately before the daily physical therapy session for a period of three weeks.

Group Type ACTIVE_COMPARATOR

REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION

Intervention Type DEVICE

theta burst stimulation (TBS) is a novel form of repetitive transcranial magnetic stimulation that mimics protocols inducing long-term potentiation (LTP) or long-term depression (LTD) in animal models. Whereas continuous TBS (cTBS) induces long-lasting inhibition of cortical areas, iTBS exerts the opposite effect, increasing cerebellar excitability

Sham iTBS

Sham intermittent theta burst stimulation applied immediately before the daily physical therapy session for a period of three weeks.

Group Type SHAM_COMPARATOR

REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION

Intervention Type DEVICE

theta burst stimulation (TBS) is a novel form of repetitive transcranial magnetic stimulation that mimics protocols inducing long-term potentiation (LTP) or long-term depression (LTD) in animal models. Whereas continuous TBS (cTBS) induces long-lasting inhibition of cortical areas, iTBS exerts the opposite effect, increasing cerebellar excitability

Interventions

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REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION

theta burst stimulation (TBS) is a novel form of repetitive transcranial magnetic stimulation that mimics protocols inducing long-term potentiation (LTP) or long-term depression (LTD) in animal models. Whereas continuous TBS (cTBS) induces long-lasting inhibition of cortical areas, iTBS exerts the opposite effect, increasing cerebellar excitability

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* First ever-chronic ischemic stroke, i.e. at least 6 months after the stroke event,
* Left or right subcortical or cortical lesion of the middle cerebral artery with medium-severity stroke NHISS \<15 (All lesions must be documented by magnetic resonance imaging (T1- and T2-weighted images; 1.5T, GE scanners)
* No contraindication to brain MRI
* MEP recordable in order to evaluate the resting motor threshold (RMT)

Exclusion Criteria

* Epilepsy
* Severe general impairment or concomitant diseases (tumors, etc.)
* Age\> 80 years
* Infections in progress
* Patients with neurological diseases beyond stroke or with neuropsychiatric disorders or with neuropsychological disorders that could potentially compromise informed consent or compliance during the study.
* Treatment with benzodiazepines, baclofen, antidepressants, clonidine, beta blockers and other potentially interfering drug treatments on plasticity phenomena.
Minimum Eligible Age

30 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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I.R.C.C.S. Fondazione Santa Lucia

OTHER

Sponsor Role lead

Responsible Party

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Giacomo Koch

Head of Laboratory

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Santa Lucia Foundation

Rome, , Italy

Site Status

Countries

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Italy

References

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Koch G, Bonni S, Casula EP, Iosa M, Paolucci S, Pellicciari MC, Cinnera AM, Ponzo V, Maiella M, Picazio S, Sallustio F, Caltagirone C. Effect of Cerebellar Stimulation on Gait and Balance Recovery in Patients With Hemiparetic Stroke: A Randomized Clinical Trial. JAMA Neurol. 2019 Feb 1;76(2):170-178. doi: 10.1001/jamaneurol.2018.3639.

Reference Type DERIVED
PMID: 30476999 (View on PubMed)

Other Identifiers

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RF-2011-02349953

Identifier Type: -

Identifier Source: org_study_id

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