rTMS Posterior Parietal Cortex Modulation and Upper Limb Movement After Stroke

Influence of the Modulation of the Posterior Parietal Cortex (rTMS) on a Pointing Movement With the Paretic Upper Limb After Stroke

This study evaluates the effect of a unique session of inhibitory rTMS (cTBS) over the contralesional posterio parietal cortex (PPC) on the spatio-temporal parameters of a pointing movement performed by stroke patients with their paretic upper limb. It will also assess the effects on the resting motor threshold of both hemispheres and on parietopremotor connectivity.

To achieve theses aims, the real cTBS stimulation will be randomly counterbalanced with a SHAM stimulation (in a second session) in a crossover design. Assessments will be performed before and after each stimulation session.

Inclusion Criteria:

• Age between 18 and 80y
• Right-handed
• Right hemispheric stroke confirmed by a 3D imaging technique
• at the chronic phase (>6months)
• subject being able to perform a pointing movement of at least 20cm in the anterior space without compensatory movements of the trunk
• informed consent
• Social security affiliation

Exclusion Criteria:

• Severe comprehension troubles (language, cognitive or psychiatric disorders)
• History of neurological disorders in addition to the stroke
• Locomotor troubles affecting the paretic arm
• Contraindication to rTMS : epilepsy, intracranial metallic foreign body, cochlear implant, unstable fracture of the skull bones, deafness
• pregnancy or breastfeeding
• adult subject to guardianship