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This pilot study will investigate the safety, feasibility, tolerability, and preliminary efficacy of accelerated high-dose repetitive transcranial magnetic stimulation (rTMS) targeting the medial prefrontal cortex (mPFC) to address apathy symptoms in individuals with chronic stroke.
Repetitive transcranial magnetic stimulation (rTMS) is a well-established FDA-approved treatment for several psychiatric indications including treatment-resistant depression, obsessive-compulsive disorder, and smoking cessation. Traditional rTMS targets the dorsolateral prefrontal cortex (dlPFC) with repetitive treatments delivered for six weeks. Recent innovations have led to the development of accelerated, high-dose rTMS protocols, with recent FDA-approval, that are capable of delivering a full treatment course within a single week.
Accumulating evidence suggests that similar neuromodulation protocols may be helpful in targeting neuropsychiatric symptoms across a range of neurologic and neurodegenerative conditions including dementia, movement disorders, and stroke. Apathy is a distinct neuropsychiatric symptom characterized by loss of motivation, withdrawal, and decreased goal-directed activity seen across a wide range of neuropsychiatric conditions. Apathy contributes significantly to lower quality of life, caregiver burnout, and poorer rehabilitation outcomes. Meanwhile, there are currently no FDA-approved treatments targeting apathy specifically. The mPFC has been well-established as a safe and feasible target for traditional rTMS, and may be a desirable stimulation site in targeting apathy due to its superficial location and integral association with other brain structures implicated in apathy pathophysiology such as the anterior cingulate cortex (ACC) and ventral striatum (VL).
This phase I open-label pilot study will investigate high-dose, accelerated rTMS at the medial prefrontal cortex (mPFC) to target apathy in individuals with chronic stroke. The primary aims of the study will be to: (1) establish the safety, feasibility, tolerability, and acceptability of an accelerated repetitive transcranial magnetic stimulation (rTMS) protocol for apathy in chronic stroke; (2) establish the feasibility of individualized resting-state functional magnetic resonance imaging (fMRI) connectivity for targeting rTMS in post-stroke apathy; (3) establish preliminary efficacy of an accelerated rTMS protocol for post-stroke apathy. Given the limited power of this small pilot study, this aim will be considered exploratory with the intention to guide future research.
Sixteen chronic stroke patients with symptomatic apathy will complete (1) structural as well as resting state functional MRI at baseline for targeting parcellations. (2) A battery of validated clinical assessments of apathy-related symptoms (3) a battery of neuropsychological, cognitive, and symptom measures to assess safety, tolerability, and feasibility. Treatment will consist of open-label, high-dose rTMS to left mPFC delivered following a standard protocol consisting of 600 pulses, twelve times per day, for three treatment days (contiguous or non-contiguous) within a seven-day period. Safety assessments will be monitored throughout treatment. A battery of clinical assessments will be repeated at the end of treatment and weekly for one month post-treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Repetitive transcranial magnetic stimulation | Experimental | All participants will receive accelerated, high-dose repetitive transcranial magnetic stimulation (rTMS) at the medial prefrontal cortex (mPFC) delivered in runs of 600 pulses, twelve times per day, for three treatment days (contiguous or non-contiguous) within a seven-day period. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MagVenture MagPro Transcranial Magnetic Stimulation (TMS) System | Device | Treatment will consist 12 approximately-three-minute sessions on each of three treatment days within a seven-day period. To promote participant adherence and retention, treatment days will not need to be contiguous. A single session consists of 600 pulses delivered to the dmPFC at an intensity of 120% resting motor threshold (rMT). 50 hz triphasic bursts will be delivered for two seconds, followed by an 8 second inter-train interval. Trains will be repeated every 10 seconds, 10 times total, for a total of 190 seconds per session. An intersession interval of at least 15 minutes will be employed between each of the 12 sessions. Each treatment day will thus last approximately 3-4 hours in duration. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Apathy Symptoms, as Measured by the Lille Apathy Rating Scale (LARS) Compared to Baseline | The Lille Apathy Rating Scale (LARS) is a validated 33-item structured interview assessing apathy across 9 domains, including intellectual curiosity, emotion, action initiation, self-awareness, productivity, interests, novelty seeking, motivation, and social engagement. Total scores range from -36 to +36, with higher scores indicating greater severity of apathy (worse outcome) and lower (more negative) scores indicating less apathy (better outcome). The total score is calculated by summing responses across all items and domains to generate a composite score. | Pre-treatment, immediately post-treatment, and at one-month follow-up |
| Treatment-Emergent Adverse Events and Side Effects as Assessed by Intermittent Theta Burst Stimulation Review of Systems (iTBS ROS) | A review of systems questionnaire (Intermittent Theta Burst Stimulation Review of Systems; iTBS ROS) was administered repeatedly during each treatment day to assess treatment-emergent symptoms. Symptoms were rated on a scale from 0 to 5 (0 = none, 1 = minimal, 2 = mild, 3 = moderate, 4 = marked, 5 = severe), with higher scores indicating greater symptom severity (worse outcome). Values reported represent the average symptom severity across all assessments collected during the 3 treatment days for each participant, and then averaged across participants. | Across the 3 rTMS treatment days |
| Change in Global Cognition, as Measured by the Montreal Cognitive Assessment (MoCA) Compared to Baseline | The Montreal Cognitive Assessment (MoCA) is a clinical assessment of cognitive function. The MoCA assesses multiple cognitive domains including memory, visuospatial skills, executive function, attention, concentration, calculation, language, abstraction, and orientation. The MoCA can be administered in approximately 10 minutes and total scores range from 0 to 30 with lower scores correlating with greater degree of cognitive impairment. | Pre-treatment, immediately post-treatment, and at one-month follow-up |
| Change From Baseline Cognition, as Measured by the Fluid Cognition Composite Score From the NIH Toolbox Cognition Battery Compared to Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Apathy Symptoms, as Measured by the Apathy Evaluation Scale (AES) Compared to Baseline | The Apathy Evaluation Scale (AES) clinically validated rating scale assessing symptoms of apathy. The AES is comprised of 18 items rated on a four-point Likert-Scale assessing and quantifying emotional, behavioral and cognitive aspects of apathy. Total scores on the AES range from 18 to 72 with high scores correlating with greater severity of apathy. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Parneet Grewal, MD | Medical University of South Carolina | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical University of South Carolina Brain Stimulation Lab | Charleston | South Carolina | 29403 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28689673 | Background | Le Heron C, Apps MAJ, Husain M. The anatomy of apathy: A neurocognitive framework for amotivated behaviour. Neuropsychologia. 2018 Sep;118(Pt B):54-67. doi: 10.1016/j.neuropsychologia.2017.07.003. Epub 2017 Jul 8. | |
| 16207933 | Background | Levy R, Dubois B. Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cereb Cortex. 2006 Jul;16(7):916-28. doi: 10.1093/cercor/bhj043. Epub 2005 Oct 5. |
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Of 21 participants who provided informed consent (enrolled), 6 were excluded prior to treatment initiation due to MRI contraindications (n=3), failure to meet apathy inclusion criteria (n=1), new neurological diagnosis (n=1), and claustrophobia (n=1). Fifteen participants met eligibility criteria and were assigned to the intervention and initiated treatment.
A total of 21 participants provided informed consent and were considered enrolled. Of these, 6 participants were excluded prior to treatment initiation due to ineligibility or withdrawal. Fifteen participants were assigned to the intervention and initiated treatment.
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| ID | Title | Description |
|---|---|---|
| FG000 | Repetitive Transcranial Magnetic Stimulation | All participants received open-label accelerated repetitive transcranial magnetic stimulation (rTMS) at the left dorsomedial prefrontal cortex (dmPFC) delivered in repeated sessions of 600 pulses of intermittent theta burst stimulation (iTBS) delivered, each consisting of 20 trains of 30 pulses in 50 Hz triplet bursts every 200 milliseconds (5 Hz Theta frequency) with 2-second trains and 8-second inter-train intervals for 190 seconds per session. Sessions were separated by a 10-15 minute inter-session interval. twelve times per day, for three treatment days (contiguous or non-contiguous) within a seven-day period. Sessions were repeated for 12 sessions per day on each of three treatment days within a 7 day window, for a total of 36 rTMS sessions and 21,600 total pulses. All participants were assessed for outcomes at baseline, immediately post-treatment, and for 1 month of post-treatment follow up. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Repetitive Transcranial Magnetic Stimulation | All participants received open-label accelerated repetitive transcranial magnetic stimulation (rTMS) at the left dorsomedial prefrontal cortex (dmPFC) delivered in repeated sessions of 600 pulses of intermittent theta burst stimulation (iTBS) delivered, each consisting of 20 trains of 30 pulses in 50 Hz triplet bursts every 200 milliseconds (5 Hz Theta frequency) with 2-second trains and 8-second inter-train intervals for 190 seconds per session. Sessions were separated by a 10-15 minute inter-session interval. twelve times per day, for three treatment days (contiguous or non-contiguous) within a seven-day period. Sessions were repeated for 12 sessions per day on each of three treatment days within a 7 day window, for a total of 36 rTMS sessions and 21,600 total pulses. All participants were assessed for outcomes at baseline, immediately post-treatment, and for 1 month of post-treatment follow up. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Apathy Symptoms, as Measured by the Lille Apathy Rating Scale (LARS) Compared to Baseline | The Lille Apathy Rating Scale (LARS) is a validated 33-item structured interview assessing apathy across 9 domains, including intellectual curiosity, emotion, action initiation, self-awareness, productivity, interests, novelty seeking, motivation, and social engagement. Total scores range from -36 to +36, with higher scores indicating greater severity of apathy (worse outcome) and lower (more negative) scores indicating less apathy (better outcome). The total score is calculated by summing responses across all items and domains to generate a composite score. | Posted | Mean | Standard Deviation | scores on a scale | Pre-treatment, immediately post-treatment, and at one-month follow-up |
|
from enrollment to the end of follow up, up to 12 weeks
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Repetitive Transcranial Magnetic Stimulation | All participants received open-label accelerated repetitive transcranial magnetic stimulation (rTMS) at the left dorsomedial prefrontal cortex (dmPFC) delivered in repeated sessions of 600 pulses of intermittent theta burst stimulation (iTBS) delivered, each consisting of 20 trains of 30 pulses in 50 Hz triplet bursts every 200 milliseconds (5 Hz Theta frequency) with 2-second trains and 8-second inter-train intervals for 190 seconds per session. Sessions were separated by a 10-15 minute inter-session interval. twelve times per day, for three treatment days (contiguous or non-contiguous) within a seven-day period. Sessions were repeated for 12 sessions per day on each of three treatment days within a 7 day window, for a total of 36 rTMS sessions and 21,600 total pulses. All participants were assessed for outcomes at baseline, immediately post-treatment, and for 1 month of post-treatment follow up. |
Not provided
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headach | Nervous system disorders | Systematic Assessment |
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Lisa McTeague | Medical University of South Carolina | 843-792-8274 | mcteague@musc.edu |
Not provided
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 9, 2024 | Apr 30, 2026 | Prot_SAP_001.pdf |
| ICF | No | No | Yes | Informed Consent Form | Mar 27, 2024 | Jun 4, 2024 | ICF_000.pdf |
Not provided
| ID | Term |
|---|---|
| D053609 | Lethargy |
| D020521 | Stroke |
| ID | Term |
|---|---|
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
Not provided
Not provided
| ID | Term |
|---|---|
| D050781 | Transcranial Magnetic Stimulation |
| D016503 | Drug Delivery Systems |
| ID | Term |
|---|---|
| D055909 | Magnetic Field Therapy |
| D013812 | Therapeutics |
| D004358 | Drug Therapy |
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single group, open-label pilot investigation
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|
|
Fluid cognition was measured using the iPad-administered NIH Toolbox Cognition Battery (NIHTB-CB). Fluid Cognition Composite scores were calculated by averaging the demographically adjusted (age, education, sex, race/ethnicity; Casaletto et al., 2015) T-scores for 5 NIHTB-CB tests: the flanker inhibitory control, list sorting working memory, pattern comparison processing speed, dimensional change card sort tests, and picture sequence memory. T-Scores have a mean of 50 and a standard deviation of 10. Lower scores indicate worse performance. There are no established thresholds or cutoffs for clinically distinct or diagnostic categories. |
| Pre-treatment, immediately post-treatment |
| Participant Retention Rate | Percentage of participants who completed the study relative to all participants who initiated treatment | calculated at the end of the study follow-up assessment period (one month post-treatment) |
| Pre-treatment, immediately post-treatment, and at one-month follow-up |
| Patient-Reported Outcomes Measurement Information System (PROMIS) Depression Short Form | The Patient-Reported Outcomes Measurement Information System (PROMIS) Depression Short Form is a validated patient-reported outcome measure assessing depressive symptoms, including negative mood, cognitive symptoms, and decreased positive affect. Scores are reported as T-scores standardized to the U.S. general population, where a T-score of 50 represents the population mean and 10 represents the standard deviation. Higher T-scores indicate greater depressive symptom severity (worse outcome), while lower T-scores indicate fewer depressive symptoms (better outcome). T-scores of approximately 60 or greater are generally considered indicative of at least mild clinically elevated depressive symptoms, with higher thresholds reflecting increasing severity. | Pre-treatment, immediately post-treatment, and at one-month follow-up |
| 20734360 | Result | Holtzheimer PE 3rd, McDonald WM, Mufti M, Kelley ME, Quinn S, Corso G, Epstein CM. Accelerated repetitive transcranial magnetic stimulation for treatment-resistant depression. Depress Anxiety. 2010 Oct;27(10):960-3. doi: 10.1002/da.20731. |
| 28578330 | Result | Sasaki N, Hara T, Yamada N, Niimi M, Kakuda W, Abo M. The Efficacy of High-Frequency Repetitive Transcranial Magnetic Stimulation for Improving Apathy in Chronic Stroke Patients. Eur Neurol. 2017;78(1-2):28-32. doi: 10.1159/000477440. Epub 2017 Jun 3. |
| 19008681 | Result | Santa N, Sugimori H, Kusuda K, Yamashita Y, Ibayashi S, Iida M. Apathy and functional recovery following first-ever stroke. Int J Rehabil Res. 2008 Dec;31(4):321-6. doi: 10.1097/MRR.0b013e3282fc0f0e. |
| 20540829 | Result | Jorge RE, Starkstein SE, Robinson RG. Apathy following stroke. Can J Psychiatry. 2010 Jun;55(6):350-4. doi: 10.1177/070674371005500603. |
| 15817019 | Result | Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221.x. |
| 16614016 | Result | Sockeel P, Dujardin K, Devos D, Deneve C, Destee A, Defebvre L. The Lille apathy rating scale (LARS), a new instrument for detecting and quantifying apathy: validation in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2006 May;77(5):579-84. doi: 10.1136/jnnp.2005.075929. |
| 26030001 | Result | Casaletto KB, Umlauf A, Beaumont J, Gershon R, Slotkin J, Akshoomoff N, Heaton RK. Demographically Corrected Normative Standards for the English Version of the NIH Toolbox Cognition Battery. J Int Neuropsychol Soc. 2015 May;21(5):378-91. doi: 10.1017/S1355617715000351. Epub 2015 Jun 1. |
| 26931289 | Result | Schalet BD, Pilkonis PA, Yu L, Dodds N, Johnston KL, Yount S, Riley W, Cella D. Clinical validity of PROMIS Depression, Anxiety, and Anger across diverse clinical samples. J Clin Epidemiol. 2016 May;73:119-27. doi: 10.1016/j.jclinepi.2015.08.036. Epub 2016 Feb 27. |
| 1754629 | Result | Marin RS, Biedrzycki RC, Firinciogullari S. Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res. 1991 Aug;38(2):143-62. doi: 10.1016/0165-1781(91)90040-v. |
| 42282206 | Derived | Seidman MB, Grewal P, Bowyer C, Dickens I, Eade J, Collins E, Patel C, Arias Velasquez DE, George MS, Antonucci M, Caulfield KA, McTeague LM. Improving Motivation in Post-stroke Apathy with Repetitive Transcranial Magnetic Stimulation (IMPART): A Phase-I Pilot Trial. medRxiv [Preprint]. 2026 Jun 5:2026.06.01.26354398. doi: 10.64898/2026.06.01.26354398. |
| years |
|
| Sex: Female, Male | Count of Participants | Participants | No |
|
| Race (NIH/OMB) | Count of Participants | Participants | No |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants | No |
|
|
|
| Primary | Treatment-Emergent Adverse Events and Side Effects as Assessed by Intermittent Theta Burst Stimulation Review of Systems (iTBS ROS) | A review of systems questionnaire (Intermittent Theta Burst Stimulation Review of Systems; iTBS ROS) was administered repeatedly during each treatment day to assess treatment-emergent symptoms. Symptoms were rated on a scale from 0 to 5 (0 = none, 1 = minimal, 2 = mild, 3 = moderate, 4 = marked, 5 = severe), with higher scores indicating greater symptom severity (worse outcome). Values reported represent the average symptom severity across all assessments collected during the 3 treatment days for each participant, and then averaged across participants. | Posted | Mean | Standard Deviation | scores on a scale | Across the 3 rTMS treatment days |
|
|
|
| Primary | Change in Global Cognition, as Measured by the Montreal Cognitive Assessment (MoCA) Compared to Baseline | The Montreal Cognitive Assessment (MoCA) is a clinical assessment of cognitive function. The MoCA assesses multiple cognitive domains including memory, visuospatial skills, executive function, attention, concentration, calculation, language, abstraction, and orientation. The MoCA can be administered in approximately 10 minutes and total scores range from 0 to 30 with lower scores correlating with greater degree of cognitive impairment. | Posted | Mean | Standard Deviation | scores on a scale | Pre-treatment, immediately post-treatment, and at one-month follow-up |
|
|
|
| Primary | Change From Baseline Cognition, as Measured by the Fluid Cognition Composite Score From the NIH Toolbox Cognition Battery Compared to Baseline | Fluid cognition was measured using the iPad-administered NIH Toolbox Cognition Battery (NIHTB-CB). Fluid Cognition Composite scores were calculated by averaging the demographically adjusted (age, education, sex, race/ethnicity; Casaletto et al., 2015) T-scores for 5 NIHTB-CB tests: the flanker inhibitory control, list sorting working memory, pattern comparison processing speed, dimensional change card sort tests, and picture sequence memory. T-Scores have a mean of 50 and a standard deviation of 10. Lower scores indicate worse performance. There are no established thresholds or cutoffs for clinically distinct or diagnostic categories. | Posted | Mean | Standard Deviation | T-score | Pre-treatment, immediately post-treatment |
|
|
|
| Primary | Participant Retention Rate | Percentage of participants who completed the study relative to all participants who initiated treatment | Posted | Count of Participants | Participants | calculated at the end of the study follow-up assessment period (one month post-treatment) |
|
|
|
| Secondary | Change in Apathy Symptoms, as Measured by the Apathy Evaluation Scale (AES) Compared to Baseline | The Apathy Evaluation Scale (AES) clinically validated rating scale assessing symptoms of apathy. The AES is comprised of 18 items rated on a four-point Likert-Scale assessing and quantifying emotional, behavioral and cognitive aspects of apathy. Total scores on the AES range from 18 to 72 with high scores correlating with greater severity of apathy. | Posted | Mean | Standard Deviation | scores on a scale | Pre-treatment, immediately post-treatment, and at one-month follow-up |
|
|
|
| Secondary | Patient-Reported Outcomes Measurement Information System (PROMIS) Depression Short Form | The Patient-Reported Outcomes Measurement Information System (PROMIS) Depression Short Form is a validated patient-reported outcome measure assessing depressive symptoms, including negative mood, cognitive symptoms, and decreased positive affect. Scores are reported as T-scores standardized to the U.S. general population, where a T-score of 50 represents the population mean and 10 represents the standard deviation. Higher T-scores indicate greater depressive symptom severity (worse outcome), while lower T-scores indicate fewer depressive symptoms (better outcome). T-scores of approximately 60 or greater are generally considered indicative of at least mild clinically elevated depressive symptoms, with higher thresholds reflecting increasing severity. | Posted | Mean | Standard Deviation | T-score | Pre-treatment, immediately post-treatment, and at one-month follow-up |
|
|
|
| 0 |
| 15 |
| 0 |
| 15 |
| 13 |
| 15 |
| Scalp pain | Skin and subcutaneous tissue disorders | Systematic Assessment | 1 |
|
| Arm/hand pain | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
|
| Other pain | General disorders | Systematic Assessment |
|
| Weakness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Loss of dexterity | General disorders | Systematic Assessment |
|
| Hearing changes | Nervous system disorders | Systematic Assessment |
|
| Ear ringing | Nervous system disorders | Systematic Assessment |
|
| Skin changes | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
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| D013568 | Pathological Conditions, Signs and Symptoms |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| Title | Measurements |
|---|---|
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| Scalp pain, treatment day 1 |
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| Scalp pain, treatment day 2 |
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| Scalp pain, treatment day 3 |
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| Arm/hand pain, treatment day 1 |
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| Arm/hand pain, treatment day 2 |
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| Arm/hand pain, treatment day 3 |
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| Other pain(s), treatment day 1 |
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| Other pain(s), treatment day 2 |
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| Other pain(s), treatment day 3 |
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| Weakness, treatment day 1 |
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| Weakness, treatment day 2 |
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| Weakness, treatment day 3 |
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| Loss of dexterity, treatment day 1 |
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| Loss of dexterity, treatment day 2 |
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| Loss of dexterity, treatment day 3 |
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| Vision change(s), treatment day 1 |
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| Vision change(s), treatment day 2 |
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| Vision change(s), treatment day 3 |
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| Hearing change(s), treatment day 1 |
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| Hearing change(s), treatment day 2 |
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| Hearing change(s), treatment day 3 |
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| Ear ringing, treatment day 1 |
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| Ear ringing, treatment day 2 |
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| Ear ringing, treatment day 3 |
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| Nausea/vomiting, treatment day 1 |
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| Nausea/vomiting, treatment day 2 |
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| Nausea/vomiting, treatment day 3 |
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| Appetite loss, treatment day 1 |
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| Appetite loss, treatment day 2 |
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| Appetite loss, treatment day 3 |
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| Rash, treatment day 1 |
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| Rash, treatment day 2 |
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| Rash, treatment day 3 |
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| Skin change(s), treatment day 1 |
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| Skin change(s), treatment day 2 |
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| Skin change(s), treatment day 3 |
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| Title | Measurements |
|---|---|
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| Title | Measurements |
|---|---|
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| Title | Measurements |
|---|---|
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