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High definition tDCS will be conducted to both stroke and healthy subjects on primary motor cortex area to explore the motor excitability changes before and after stimulation. In next stage, a randomized control trial with 20-session training will be conducted to evaluate the effectiveness of transient modulation of cortical excitability through multisite HD-tDCS with EMG driven robot hand training, a sham stimulation with EMG-driven robot hand training will be applied as control group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Anode HD-tDCS | Experimental | The center anode is fixed on the ipsilesional primary motor cortex and the 4 surrounding cathode electrodes will be placed about 6 cm to the center. |
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| Cathode HD-tDCS | Experimental | The center cathode is fixed on the contralesional primary motor cortex and the 4 surrounding anode electrodes will be placed about 6 cm to the center. |
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| Sham HD-tDCS | Placebo Comparator | The center anode is fixed on the ipsilesional primary motor cortex and the 4 surrounding cathode electrodes will be placed about 6 cm to the center. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HD-tDCS | Device | Different stimulation protocols will be applied to the primary motor cortex of stroke patients. After 20-minute stimulation, EMG-driven robot hand training will be conducted. |
| Measure | Description | Time Frame |
|---|---|---|
| Electroencephalography (EEG) and Electromyography (EMG) | It is used to investigate the changes in corticomuscular coherence for studying connectivity between the brainwave using EEG and the affected hand muscles using EMG. In addition, EMG will be used to detect muscle activation change and muscle co-contraction pattern alteration. | Before intervention, During intervention, After intervention, 6-month after intervention |
| Action Research Arm Test (ARAT) | The ARAT is a 19-item measure divided into 4 sub-tests (grasp, grip, pinch, and gross arm movement) to assess upper limb functioning | Before intervention, After intervention, 6-month after intervention |
| Fugl-Meyer Assessment Upper Extremity (FMA-UE) | It is used to evaluate and measure upper-limb recovery in post-stroke hemiplegic patients, and items are scored on a 3-point ordinal scale | Before intervention, After intervention, 6-month after intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Magnetic Resonance Imaging (MRI) | It is used to identify neural correlates of stimulation-induced behavioral gains for investigating tDCS-induced changes in brain activations | Before intervention, After intervention, 6-month after intervention |
| Transcranial Magnetic Stimulation (TMS) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Raymond Kai-yu Tong, PhD | Contact | +852 3943 8454 | kytong@cuhk.edu.hk |
| Name | Affiliation | Role |
|---|---|---|
| Raymond Kai-yu Tong, PhD | Department of Biomedical Engineering, CUHK | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Biomedical Engineering, The Chinese University of Hong Kong | Recruiting | Hong Kong | Hong Kong |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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It is used to measure the changes in interhemispheric imbalance and corticospinal excitability |
| Before intervention |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |