Clinical, Electrophysiological and E-field Modelling Evidence of High Density Transcranial Direct Current Stimulation in Motor Stroke

NCT ID: NCT05329818

Last Updated: 2022-04-15

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-15

Study Completion Date

2023-06-15

Brief Summary

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The present study aims to investigate the therapeutic potential of a high definition transcranial direct current stimulation protocol, stimulating frontal and cerebellar areas boosting the cognitive and motor recovery of stroke population.

Detailed Description

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Stroke cause direct network dysfunctions correlating with the underlying behavioral deficits In that context, characterize and boost neuronal reshaping towards a favorable state for recovery has become a distinguished therapeutic approach. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation able to locally modulate neuronal activity and modify neural arquitecture.

In such scenario, the investigators develop in this protocol a new tDCS multitarget fronto-cerebellar tDCS approach, exploring the benefits of boosting motor dysfunctions by means of a dual site-approach, up-regulating dlPFC and CB activity. The investigators here design a pilot experimental clinical trial exploring the accumulative clinical potential for motor skill \& learning recovery and EEG effects of a high-density bifocal transcranial direct current stimulation protocol (HD-tDCS).

The investigators hypothesize that the tDCS protocol will promote direct functional motor reorganization helping relearning motor process, will boost the activity of prefrontal settled systems correcting attentional deficits and increasing strength connectivity with premotor systems, and will normalize large-scale abnormalities increasing interhemispheric functional connectivity (i.e., functional integration), decreasing interhemispheric asymmetry (i.e., functional segregation) and restoring transcallosal balance, impacting positively either in motor and cognitive recovery. All in all, this study will be the first exploring the simultaneous modulation of two different targets in stroke population corresponding to different networks looking for a summative/synergistic effects helping motor and cognitive functions recovery.

Conditions

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Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Double blind

Study Groups

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Prefrontal stimulation.

Participants receive anodal tDCS on the ipsilesional dlPFC for 5days/week for 2 weeks.

Group Type EXPERIMENTAL

high definition transcranial direct current stimulation

Intervention Type DEVICE

Non-invasive brain stimulation neuromodulation using HD (3,14cm\^2) gel based round electrodes. Scalp electrode locations will be positioned based on a optimized biophysical solution targeting ipsilesional dlPFC and the contralesional anterior cerebellum.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 1.73mA. Patients in the cerebellar stimulation group will receive 20 min of HD-tDCS with 2.0mA.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 3.73 mA.

Patients in the sham stimulation group will receive 20 min of sham HD-tDCS, with 30 seconds ramp-up and 30 seconds ramp-down.

Cerebellar stimulation.

Participants receive anodal tDCS on the contralesional cerebellum for 5days/week for 2 weeks. min of HD-tDCS with 2.0mA.

Group Type EXPERIMENTAL

high definition transcranial direct current stimulation

Intervention Type DEVICE

Non-invasive brain stimulation neuromodulation using HD (3,14cm\^2) gel based round electrodes. Scalp electrode locations will be positioned based on a optimized biophysical solution targeting ipsilesional dlPFC and the contralesional anterior cerebellum.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 1.73mA. Patients in the cerebellar stimulation group will receive 20 min of HD-tDCS with 2.0mA.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 3.73 mA.

Patients in the sham stimulation group will receive 20 min of sham HD-tDCS, with 30 seconds ramp-up and 30 seconds ramp-down.

Fronto-cerebellar stimulation.

Participants receive simultaneous anodal tDCS on the ipsilesional dlPFC and in contralesional cerebellum for 5days/week for 2 weeks.

Group Type EXPERIMENTAL

high definition transcranial direct current stimulation

Intervention Type DEVICE

Non-invasive brain stimulation neuromodulation using HD (3,14cm\^2) gel based round electrodes. Scalp electrode locations will be positioned based on a optimized biophysical solution targeting ipsilesional dlPFC and the contralesional anterior cerebellum.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 1.73mA. Patients in the cerebellar stimulation group will receive 20 min of HD-tDCS with 2.0mA.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 3.73 mA.

Patients in the sham stimulation group will receive 20 min of sham HD-tDCS, with 30 seconds ramp-up and 30 seconds ramp-down.

Sham stimulation.

Participants receive sham tDCS for 5days/week for 2 weeks.

Group Type SHAM_COMPARATOR

high definition transcranial direct current stimulation

Intervention Type DEVICE

Non-invasive brain stimulation neuromodulation using HD (3,14cm\^2) gel based round electrodes. Scalp electrode locations will be positioned based on a optimized biophysical solution targeting ipsilesional dlPFC and the contralesional anterior cerebellum.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 1.73mA. Patients in the cerebellar stimulation group will receive 20 min of HD-tDCS with 2.0mA.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 3.73 mA.

Patients in the sham stimulation group will receive 20 min of sham HD-tDCS, with 30 seconds ramp-up and 30 seconds ramp-down.

Interventions

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high definition transcranial direct current stimulation

Non-invasive brain stimulation neuromodulation using HD (3,14cm\^2) gel based round electrodes. Scalp electrode locations will be positioned based on a optimized biophysical solution targeting ipsilesional dlPFC and the contralesional anterior cerebellum.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 1.73mA. Patients in the cerebellar stimulation group will receive 20 min of HD-tDCS with 2.0mA.

Patients in the prefrontal stimulation group will receive 20 min of HD-tDCS with 3.73 mA.

Patients in the sham stimulation group will receive 20 min of sham HD-tDCS, with 30 seconds ramp-up and 30 seconds ramp-down.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Received a diagnosis of supratentorial ischemic or hemorrhagic stroke confirmed by neuroimage (MRI, PET, CT, fMRI or DTI) in the middle cerebral artery territory or encompassing fronto-temporo-parietal hemorrhages
* Enrolled in a live rehabilitation program in the rehabilitation and physical medicine department
* Between 4 and 12 months after stroke episode
* Have signed the informed form

Exclusion Criteria

* Medical instability with the presence of infections, assisted ventilation, epilepsy or recurrent seizures, untreated psychiatric disorders or an active treatment with sedative drugs
* tDCS contraindications as defined by the international safety guidelines
* Large aphasic, psychiatric and cognitive deficits limiting patient's comprehension
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Xavier Corominas

OTHER

Sponsor Role lead

Responsible Party

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Xavier Corominas

Principal investigator

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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University Hospital Joan XXIII

Tarragona, Catalonia, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Maria Teresa Colomina Fosch, MD, PhD

Role: CONTACT

+34977558153

Facility Contacts

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Maria Teresa Colomina Fosch, MD, PhD

Role: primary

+34977558153

References

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Corominas-Teruel X, Bracco M, Fibla M, Segundo RMS, Villalobos-Llao M, Gallea C, Beranger B, Toba M, Valero-Cabre A, Colomina MT. High-density transcranial direct current stimulation to improve upper limb motor function following stroke: study protocol for a double-blind randomized clinical trial targeting prefrontal and/or cerebellar cognitive contributions to voluntary motion. Trials. 2023 Dec 4;24(1):783. doi: 10.1186/s13063-023-07680-8.

Reference Type DERIVED
PMID: 38049806 (View on PubMed)

Other Identifiers

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077/2021

Identifier Type: -

Identifier Source: org_study_id

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