Interhemispheric Connectivity and Compensation

NCT ID: NCT05207878

Last Updated: 2025-10-09

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 120 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-12-09
• Study Completion Date: 2025-08-01

Brief Summary

The goal of this study is to determine which parts of the brain make it possible for some people to move skillfully with their left non-dominant hand.

Detailed Description

This is a one-visit study, in which right-handed participants (individuals with unilateral peripheral nerve injury to the right upper limb, and healthy controls) will complete surveys and perform movement tasks. Movement tasks will be performed inside and outside a magnetic resonance imaging (MRI) scanner.

Some participants will also receive transcranial magnetic stimulation (TMS) to briefly interfere with these putative brain networks.

Conditions

Peripheral Nerve Injury Upper Limb; Healthy

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: BASIC_SCIENCE
• Blinding Strategy: NONE

Study Groups

Movement task

All participants perform the STEGA-MRI (standardized tracing evaluation & grapheme assessment - MRI) precision drawing task during fMRI scanning.

Motor assessments outside the MRI do not qualify as interventions.

Group Type: EXPERIMENTAL

STEGA-MRI

Intervention Type: OTHER

Precision drawing task (movement assessment)

Interventions

STEGA-MRI

Precision drawing task (movement assessment)

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. Age ≥ 18

2. English speaking and reading

3. Able to fit in Prisma scanner bore (60 cm diameter)

4. Right hand dominant (self report, and Edinburgh handedness ≥ +40)

1. Chronic unilateral upper extremity peripheral nerve injury to the right side

• "Chronic" defined as ≥ 6 months since injury
• "Upper extremity" defined as hand, arm, or shoulder (including e.g. brachial plexus)
• "Injury" defined as localized cause (e.g. mechanical/tumor, not distributed pathology), including compression

2. Some impairment to writing, requiring both of:

• Difficulty writing, as determined by score 2+ (Mild+) on "How much difficulty have you had in the last week with writing?" (From Disabilities of the Arm, Shoulder, and Hand survey question #2)
• Box and Blocks motor performance ≥1 standard deviation below the mean of age-matched healthy adults (Mathiowetz et al. 1985, AJOT).

Exclusion Criteria

1. Currently intoxicated or otherwise non-compliant

2. Chronic pain diagnosis unrelated to the nerve injury

3. Uncorrected visual impairment that interferes with ability to see drawings in MRI

4. Motor function diagnoses that affect function of the left hand, now or in past 2 years

5. Motor function diagnoses currently affecting the right hand, unrelated to the nerve injury

• This is not meant to exclude a single event with complex consequences (e.g. nerve and tendon)
• This is not meant to exclude multiple nerve injuries in the same arm, if each one is eligible (II.B.1)
• This is meant to exclude e.g. injury and unrelated musculoskeletal disorder in same arm

6. Upper extremity surgery, including peripheral nerve surgery, within last 2 months

7. Contraindication for MRI

8. Contraindication for transcranial magnetic stimulation (TMS)

• May exclude from TMS only (since not all participants undergo TMS), or exclude from full study

9. Amputation affecting any part of thumb, index, or middle fingers (including higher level, e.g. whole hand)

10. History of chronic cocaine use (based on medical record or volunteered; will not actively inquire)

11. Diagnosis of schizophrenia or other rare psychiatric disorder

• This is not meant to exclude depression or anxiety

12. History of major neurological diagnosis, e.g. stroke, traumatic brain injury, Alzheimer's, Parkinson's

• This is not meant to exclude concussion UNLESS < 6 months ago, or post-concussion syndrome (diagnosed or self-report)

1. Motor function diagnoses that affect function of either hand, now or in past 2 years

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role: collaborator

Washington University School of Medicine

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Benjamin A Philip, PhD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

Washington University School of Medicine

St Louis, Missouri, United States

Countries

United States

Provided Documents

Document Type: Informed Consent Form

View Document

Other Identifiers

R01NS114046-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

202009183

Identifier Type: -

Identifier Source: org_study_id