Brain STimulation for Arm Recovery After Stroke 2

NCT ID: NCT06265766

Last Updated: 2025-08-27

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

RECRUITING

Clinical Phase

NA

Total Enrollment

454 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-09

Study Completion Date

2029-12-31

Brief Summary

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Rationale: Every year, about 40,000 people in the Netherlands have a stroke. After the initial admission to the hospital, about 15% of stroke survivors is admitted to a rehabilitation center because of remaining disabilities. Three out of four of these patients have upper limb dysfunction, hampering activities of daily living. Upper limb function plays a critical role in the performance of most daily life activities. In our phase II trial B-STARS, continuous theta burst stimulation (cTBS) treatment led to an absolute additional recovery of upper limb function of 17%, as measured with the Action Research Arm Test (ARAT) score three months after stroke. This improvement exceeds the minimal clinically important difference of 10%. cTBS treatment also resulted in a significant improvement in measures of activities and participation (of similar magnitude) and a reduction in the mean length of stay at the rehabilitation center by 18 days.

Objective: To assess the effectiveness and cost effectiveness of cTBS treatment in promoting upper limb recovery after stroke in patients admitted to a rehabilitation center.

Study design: A phase III, multi-center, double-blind, randomized, sham-controlled, clinical trial.

Study population: 454 patients aged 18 years or older with a first-ever ischemic stroke or intracerebral hemorrhage and a unilateral arm paresis, defined by a Motricity Index between 9 and 99, in whom cTBS treatment can be started within 3 weeks after stroke onset.

Intervention: 10 daily sessions of cTBS delivered over the contralesional primary motor cortex during a period of 2 weeks, delivered immediately before regular care physical therapy of the affected upper limb.

Main study parameters/endpoints: The primary endpoint will be the score on the upper extremity section of the Fugl-Meyer assessment (FM-UE) at 90 days after stroke. Secondary endpoints will include the score on the FM-UE at one year and the scores on the Action Research Arm Test, Nine Hole Peg Test, Stroke Impact Scale, EuroQol 5 Dimensions and modified Rankin Scale at 90 days and one year after stroke

Detailed Description

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Conditions

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Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
Sham cTBS treatment is delivered with a sham TMS-coil.

Study Groups

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Active cTBS

Active cTBS delivered with an active TMS coil

Group Type EXPERIMENTAL

Active cTBS

Intervention Type DEVICE

10 sessions of active cTBS delivered to the contralesional primary motor cortex, started within 3 weeks after stroke.

Sham cTBS

Sham cTBS delivered with a sham TMS coil

Group Type SHAM_COMPARATOR

Sham cTBS

Intervention Type DEVICE

10 sessions of sham cTBS delivered to the contralesional primary motor cortex, started within 3 weeks after stroke.

Interventions

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Active cTBS

10 sessions of active cTBS delivered to the contralesional primary motor cortex, started within 3 weeks after stroke.

Intervention Type DEVICE

Sham cTBS

10 sessions of sham cTBS delivered to the contralesional primary motor cortex, started within 3 weeks after stroke.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age, 18 years or older
* First-ever unilateral ischemic stroke or intracerebral hemorrhage in a cerebral hemisphere or the brainstem;
* Unilateral upper limb paresis with a motricity index between 9 and 99;
* Possibility to start cTBS treatment within 21 days after stroke onset;
* Signed informed consent.

Exclusion Criteria

* Upper limb paresis prior to stroke onset;
* Absolute contra-indication to TMS
* Magnetic sensitive objects implanted in the head or neck area (e.g. cochlear implants, implanted neurostimulator, pacemaker or defibrillator, metal splinters, metal fragments or metal clips);
* History of epilepsy;
* Other contra-indications that may potentially be harmful as determined by the treating rehabilitation physician;
* Severe impairments that can impede study participation as determined by the treating rehabilitation physician (i.e. extreme fatigue, severe communication deficits);
* Life expectancy shorter than one year.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jord Vink

OTHER

Sponsor Role lead

Responsible Party

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Jord Vink

dr.

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Tolbrug

's-Hertogenbosch, , Netherlands

Site Status NOT_YET_RECRUITING

Reade

Amsterdam, , Netherlands

Site Status RECRUITING

Revalidatie Friesland

Beetsterzwaag, , Netherlands

Site Status RECRUITING

Revant

Breda, , Netherlands

Site Status RECRUITING

MRC Aardenburg

Doorn, , Netherlands

Site Status NOT_YET_RECRUITING

Libra Blixembosch

Eindhoven, , Netherlands

Site Status RECRUITING

University Medical Center Groningen

Groesbeek, , Netherlands

Site Status NOT_YET_RECRUITING

Merem

Hilversum, , Netherlands

Site Status RECRUITING

Adelante

Hoensbroek, , Netherlands

Site Status RECRUITING

Basalt

Leiden, , Netherlands

Site Status RECRUITING

Sint Maartenskliniek

Nijmegen, , Netherlands

Site Status RECRUITING

Basalt

The Hague, , Netherlands

Site Status RECRUITING

Libra Leijpark

Tilburg, , Netherlands

Site Status RECRUITING

De Hoogstraat

Utrecht, , Netherlands

Site Status RECRUITING

Heliomare

Wijk aan Zee, , Netherlands

Site Status RECRUITING

Vogellanden

Zwolle, , Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Jord Vink, PhD

Role: CONTACT

+31634959811

Facility Contacts

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Cynthia Klinkers

Role: primary

Celine Timmermans

Role: primary

Wietske Rienstra

Role: primary

Marissa Riemens

Role: primary

Lisa Kruisheer

Role: primary

Daphne Stranders

Role: primary

Henk Meulenbelt

Role: primary

Maijke van Bloemendaal

Role: primary

Karin Peek

Role: backup

Carlijn Wiertz

Role: primary

+31 45 528 2828

Annelies Mantje

Role: primary

Nelleke Kooiman

Role: primary

Lotte Mulder

Role: primary

0031703593500

Iris Habets

Role: primary

Mirjam Kouwenhoven

Role: primary

Deborah Wit

Role: primary

Bente Visser

Role: primary

Other Identifiers

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85511

Identifier Type: OTHER

Identifier Source: secondary_id

NL85511.041.24

Identifier Type: -

Identifier Source: org_study_id

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